Post-transplantation cyclophosphamide and cyclosporine A versus methotrexate and cyclosporine A for graft-versus-host disease prophylaxis after allogeneic peripheral stem cell transplantation in adult acute myeloid leukemia patients.
Toxicol Appl Pharmacol
; 491: 117071, 2024 Oct.
Article
en En
| MEDLINE
| ID: mdl-39159847
ABSTRACT
BACKGROUND:
Different prophylactic protocols are available for preventing graft-versus-host disease (GVHD) after matched sibling donor (MSD) allogeneic hematopoietic cell transplantation (allo-HCT). This study aimed to compare the effectiveness of post-transplantation cyclophosphamide plus cyclosporine A (PT-CY/CSA) versus methotrexate plus CSA (MTX/CSA) as GVHD prophylaxis protocols in adult acute myeloid leukemia (AML) patients who received peripheral blood stem cells (PBSC) from fully matched donors.METHODS:
The 1-year outcomes of 89 patients treated with PT-CY/CSA and 90 patients treated with MTX/CSA who had MSD allo-HCT for AML using unmanipulated mobilized PBSC were examined and compared.RESULTS:
The cumulative incidence of acute GVHD at 100 days was considerably lower in the PT-CY/CSA group (4% vs 19.3%, p = 0.002), however there were no statistically significant difference in the cumulative incidence of chronic GVHD at 1-year (19.6% vs 37.4%, p = 0.053). Significant delays in neutrophil and platelet engraftments were reported in the PT-CY/CSA group (17 vs 12 days) and (13 vs 12 days), respectively (p < 0.001). The cumulative incidences of relapse (19.1% vs 13.7%, p = 0.470), overall survival (79.1% vs 77.3%, p = 0.986), non-relapse mortality (16.5% vs 16.8%, p = 0.837), and the GVHD and relapse-free survival (GRFS) (53.7% vs 46.6%, p = 0.478) did not differ statistically at 1-year.CONCLUSION:
PT-CY/CSA demonstrated a significant decrease in the rate of acute GVHD. However, it was associated with engraftment delay.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Trasplante Homólogo
/
Leucemia Mieloide Aguda
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Metotrexato
/
Ciclosporina
/
Ciclofosfamida
/
Trasplante de Células Madre de Sangre Periférica
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Enfermedad Injerto contra Huésped
Idioma:
En
Revista:
Toxicol Appl Pharmacol
/
Toxicol. appl. pharmacol
/
Toxicology and applied pharmacology
Año:
2024
Tipo del documento:
Article