Post-transplant cyclophosphamide and sirolimus based graft-versus-host disease prophylaxis after allogeneic stem cell transplantation for acute myeloid leukemia.

Autores de IIS La Fe

• Aitana Balaguer Roselló

  Autor

• Juan Bautista Montoro Gómez

  Autor

• Marta Villalba Montaner

  Autor

• Manuel Nuno Direito De Morais Guerreiro

  Autor

• José Luis Piñana Sánchez

  Autor

• Miguel Ángel Sanz Alonso

  Autor

• Carlos Solano Vercet

  Autor

• 

  Javier De La Rubia Comos

  Autor

• Jaime Sanz Caballer

  Autor

Participantes ajenos a IIS La Fe

• Lazzari, Lorenzo
• Greco, Raffaella
• Hernani, Rafael
• Lupo-Stanghellini, Maria Teresa
• Giglio, Fabio
• Facal, Ana
• Lorentino, Francesca
• Bruno, Alessandro
• Perez, Ariadna
• Xue, Elisabetta
• Clerici, Daniela
• Piemontese, Simona
• Ciceri, Fabio
• Peccatori, Jacopo

Grupos

• Hematología y Hemoterapia

Abstract

Post-transplant cyclophosphamide (PTCy) has emerged as a promising graft-versus-host disease (GvHD) prophylaxis in allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, no studies have reported the efficacy of a GvHD prophylaxis based on PTCy with sirolimus (Sir-PTCy) in patients with acute myeloid leukemia (AML). In this retrospective study, we analyze the use of sirolimus in combination with PTCy, with or without mycophenolate mofetil (MMF), on 242 consecutive adult patients with AML undergoing a myeloablative first allo-HSCT from different donor types, in three European centers between January 2017 and December 2020. Seventy-seven (32%) patients received allo-HSCT from HLA-matched sibling donor, 101 (42%) from HLA-matched and mismatched unrelated donor, and 64 (26%) from haploidentical donor. Except for neutrophil and platelet engraftment, which was slower in the haploidentical cohort, no significant differences were observed in major transplant outcomes according to donor type in univariate and multivariate analysis. GvHD prophylaxis with Sir-PTCy, with or without MMF, is safe and effective in patients with AML undergoing myeloablative allo-HSCT, resulting in low rates of transplant-related mortality, relapse/progression, and acute and chronic GvHD in all donor settings.

© 2022. The Author(s).

Keywords

• 1ST COMPLETE REMISSION; HEMATOLOGIC MALIGNANCIES; MARROW-TRANSPLANTATION; CONDITIONING INTENSITY; GVHD PROPHYLAXIS; EUROPEAN-SOCIETY; RISK INDEX; OPEN-LABEL; BLOOD; DIAGNOSIS