Characterization of Chronic Graft-versus-host Disease After Haploidentical Stem Cell Transplantation With Posttransplant Cyclophosphamide: A Study on Behalf of GETH-TC
Por:
Fonseca-Santos, M, Bailen, R, Lopez-Godino, O, Herruzo-Delgado, B, Bermudez, MA, García-Cadenas, I, Huguet-Mas, M, Ferra-Coll, C, Esquirol, A, Cortés-Rodriguez, M, Yañez-Sansegundo, L, Pascual-Cascon, MJ, Heras, I, Kwon, M and Lopez-Corral, L
Publicada:
1 oct 2024
Ahead of Print:
24 sep 2024
Resumen:
Background.Chronic graft-versus-host disease (cGVHD) is a cause of late morbidity and nonrelapse mortality (NRM) after allogenic hematopoietic stem cell transplantation (allo-HSCT). Although studies evaluating haploidentical allo-HSCT (haplo-HSCT) using posttransplant cyclophosphamide (PTCy) demonstrate lower cGVHD rates, comprehensive data describing the clinical profile, risk factors, or outcomes of cGVHD within this platform are scarce.Methods.We conducted a retrospective multicenter analysis of 389 consecutive patients who underwent haplo-HSCT PTCy in 7 transplant centers of the Spanish Group Grupo Espa & ntilde;ol de Trasplante Hematopoy & eacute;tico y Terapia Celular (GETH-TC) between 2008 and 2020 describing incidence, clinical profile, risk factors, and cGVHD outcomes.Results.Ninety-five patients of 389 developed cGVHD. Our data revealed that the incidence and severity of cGVHD are lower than those reported for HLA-identical transplantation with conventional prophylaxis and that the strongest predictor for cGVHD was previous acute GVHD (P = 0.031). Also, recipient age >= 60 y (P = 0.044) was protective against cGVHD. Moreover, patients with moderate cGVHD had longer event-free survival at 3 y than other patients (P = 0.016) and a lower relapse rate at 3 y (P = 0.036).Conclusions.Our results support the fact that the incidence and severity of cGVHD are lower than those reported for HLA-identical transplantation with conventional prophylaxis. In this series, patients who develop moderate cGVHD after haplo-HSCT PTCy had a higher overall survival and event-free survival, and lower relapse, suggesting higher graft-versus-leukemia effect. Although this is the largest series focused on characterizing cGVHD in haplo-HSCT PTCy, further prospective studies are needed to confirm the findings.
Filiaciones:
Fonseca-Santos, M:
IBSAL, Hosp Univ Salamanca, Ctr Invest Canc IBMCC USAL CSIC, Hematol Dept,CIBERONC, Salamanca, Spain
Bailen, R:
Hosp Gen Univ Gregorio Maranon, Hematol Dept, Madrid, Spain
Lopez-Godino, O:
Hosp Univ Morales Meseguer, Hematol Dept, Murcia, Spain
Herruzo-Delgado, B:
Univ Malaga, Hosp Reg, Hematol Dept, Malaga, Spain
Bermudez, MA:
Hosp Univ Marques Valdecilla, Serv Hematol & Hemoterapia, Santander, Spain
García-Cadenas, I:
Hosp St Creu I St Pau, Hematol Dept, Barcelona, Spain
Huguet-Mas, M:
Hosp Badalona Germans Trias & Pujol, Hematol Dept, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Hematol Dept, Barcelona, Spain
Esquirol, A:
Hosp St Creu I St Pau, Hematol Dept, Barcelona, Spain
Cortés-Rodriguez, M:
IBSAL, Hosp Univ Salamanca, Ctr Invest Canc IBMCC USAL CSIC, Hematol Dept,CIBERONC, Salamanca, Spain
Univ Salamanca, Stat Dept, Salamanca, Spain
Yañez-Sansegundo, L:
Hosp Univ Marques Valdecilla, Serv Hematol & Hemoterapia, Santander, Spain
Pascual-Cascon, MJ:
Univ Malaga, Hosp Reg, Hematol Dept, Malaga, Spain
Heras, I:
Hosp Univ Morales Meseguer, Hematol Dept, Murcia, Spain
Kwon, M:
Hosp Gen Univ Gregorio Maranon, Hematol Dept, Madrid, Spain
Lopez-Corral, L:
IBSAL, Hosp Univ Salamanca, Ctr Invest Canc IBMCC USAL CSIC, Hematol Dept,CIBERONC, Salamanca, Spain
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