Posttransplantation cyclophosphamide for prevention of graft-versus-host disease after HLA-matched mobilized blood cell transplantation.

Blood
Marco MielcarekPaul J Martin

Abstract

The cumulative incidence of National Institutes of Health (NIH)-defined chronic graft-versus-host disease (GVHD) requiring systemic treatment is ∼35% at 1 year after transplantation of granulocyte colony-stimulating factor (G-CSF)-mobilized blood cells from HLA-matched related or unrelated donors. We hypothesized that high-dose cyclophosphamide given after G-CSF-mobilized blood cell transplantation would reduce the cumulative 1-year incidence of chronic GVHD to 15% or less. Forty-three patients with high-risk hematologic malignancies (median age, 43 years) were enrolled between December 2011 and September 2013. Twelve (28%) received grafts from related donors, and 31 (72%) received grafts from unrelated donors. Pretransplant conditioning consisted of fludarabine and targeted busulfan (n = 25) or total body irradiation (≥12 Gy; n = 18). Cyclophosphamide was given at 50 mg/kg per day on days 3 and 4 after transplantation, followed by cyclosporine starting on day 5. The cumulative 1-year incidence of NIH-defined chronic GVHD was 16% (95% confidence interval, 5-28%). The cumulative incidence estimates of grades 2-4 and 3-4 acute GVHD were 77% and 0%, respectively. At 2 years, the cumulative incidence estimates of nonrelapse mortali...Continue Reading

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Citations

Sep 11, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Xiao-Dong MoXiao-Jun Huang
Apr 12, 2017·Expert Review of Hematology·Alberto MussettiPaolo Corradini
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Aug 23, 2019·Bone Marrow Transplantation·Stefan O Ciurea
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Sep 19, 2019·Nature Reviews. Rheumatology·Keith M Sullivan, Stefanie Sarantopoulos
May 8, 2020·Journal of Hematology & Oncology·Jaime SanzUNKNOWN Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)
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Jan 13, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Shernan G HoltanJan J Cornelissen

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