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OCTET-CY: a phase II study to investigate the efficacy of post-transplant cyclophosphamide as sole graft-versus-host prophylaxis after allogeneic peripheral blood stem cell transplantation
| Content Provider | Scilit |
|---|---|
| Author | Holtick, Udo Chemnitz, Jens-Markus Shimabukuro-Vornhagen, Alexander Theurich, Sebastian Chakupurakal, Geothy Krause, Anke Fiedler, Anne Luznik, Leo Hellmich, Martin Wolf, Dominik Hallek, Michael von Bergwelt-Baildon, Michael Scheid, Christof |
| Copyright Year | 2015 |
| Description | Journal: European Journal of Haematology Post-transplant cyclophosphamide is increasingly used as graft-versus-host disease (GvHD) prophylaxis in the setting of bone marrow transplantation. No data have been published on the use of single-agent GvHD prophylaxis with post-transplant cyclophosphamide in the setting of peripheral blood stem cell transplantation (PBSCT). In a phase II trial, 11 patients with myeloma or lymphoma underwent conditioning with fludarabine and busulfan followed by T-replete PBSCT and application of 50 mg/kg/d of cyclophosphamide on day+3 and +4 without other concurrent immunosuppression (IS). Median time to leukocyte, neutrophil, and platelet engraftment was 18, 21, and 18 d. The incidence of grade II-IV and grade III-IV GvHD was 45% and 27%, with a non-relapse mortality (NRM) of 36% at one and 2 yr. After median follow-up of 927 d, overall and relapse-free survival was 64% and 34%. Three patients did not require any further systemic IS until day+100 and thereafter. Analysis of immune reconstitution demonstrated rapid T- and NK-cell recovery. B- and CD3+/CD161+NK/T-cell recovery was superior in patients not receiving additional IS. Post-transplant cyclophosphamide as sole IS in PBSCT is feasible and allows rapid immune recovery. Increased rates of severe acute GvHD explain the observed NRM and may advise a temporary combination partner such as mTor-inhibitors in the PBSCT setting. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4844370/pdf |
| Ending Page | 35 |
| Page Count | 9 |
| Starting Page | 27 |
| e-ISSN | 16000609 |
| DOI | 10.1111/ejh.12541 |
| Journal | European Journal of Haematology |
| Issue Number | 1 |
| Volume Number | 96 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2015-03-16 |
| Access Restriction | Open |
| Subject Keyword | Journal: European Journal of Haematology Allogeneic Hematopoietic Stem Cell Transplantation Graft-versus-host Disease Post-transplant Cyclophosphamide |
| Content Type | Text |
