PDF(Pubmed)
Abstract：
UNASSIGNED: Post-transplantation cyclophosphamide (PT-Cy) use is a recent graft-versus-host disease (GVHD) prophylaxis strategy for patients undergoing allogeneic stem cell transplantation (allo-HSCT). PT-Cy combined with two immunosuppressants is now widely used after haplo-identical (haplo) and HLA-matched peripheral blood stem cell (PBSC) transplantations with promising GVHD and relapsefree survival (GRFS) probabilities. Although appealing, these results may benefit from improvement notably outside matched sibling donor transplantation, and should be investigated in various ethnic populations.
UNASSIGNED: Therefore, we report our experience of GVHD prophylaxis regimen combining PT-Cy and tacrolimus with addition of post-engraftment low-dose anti-thymocyte globulin (ATG) in allogeneic stem cell transplantation from haplo-identical donors (Haplo). Sixtyseven patients were included in the analysis. All patients received myeloablative or intensified sequential conditioning regimen.
UNASSIGNED: The median follow-up was 521 (range, 10~991) days. The cumulative incidences of 100-day grade II-IV acute GVHD was 14.9±4.4%, and no case of grade III-IV acute GVHD was documented. The cumulative incidences of 2-yearchronic GVHD and moderate-to-severe chronic GVHD were 25.4±5.4% and 11.9±4%, respectively. The non-relapse mortality at day+100 and 2year were 7.5±3.2% and 9.0±3.5%, respectively. The cumulative incidence of relapse at 2year was 16±6.4%. The 2-year probability of DFS and OS were 73.8% (95%CI, 61.5~88.4%) and 72.5% (95% CI, 57.1~92.1%), respectively. The 2-year GRFS was estimated as 63.6% (95%CI, 50.6~80%).
UNASSIGNED: Our results suggested that a combination of PT-Cy, tacrolimus, and low-dose post-engraftment ATG was a promising GVHD prophylaxis with low incidence of acute GVHD in the haplo-transplantation setting.
UNASSIGNED: Therefore, we report our experience of GVHD prophylaxis regimen combining PT-Cy and tacrolimus with addition of post-engraftment low-dose anti-thymocyte globulin (ATG) in allogeneic stem cell transplantation from haplo-identical donors (Haplo). Sixtyseven patients were included in the analysis. All patients received myeloablative or intensified sequential conditioning regimen.
UNASSIGNED: The median follow-up was 521 (range, 10~991) days. The cumulative incidences of 100-day grade II-IV acute GVHD was 14.9±4.4%, and no case of grade III-IV acute GVHD was documented. The cumulative incidences of 2-yearchronic GVHD and moderate-to-severe chronic GVHD were 25.4±5.4% and 11.9±4%, respectively. The non-relapse mortality at day+100 and 2year were 7.5±3.2% and 9.0±3.5%, respectively. The cumulative incidence of relapse at 2year was 16±6.4%. The 2-year probability of DFS and OS were 73.8% (95%CI, 61.5~88.4%) and 72.5% (95% CI, 57.1~92.1%), respectively. The 2-year GRFS was estimated as 63.6% (95%CI, 50.6~80%).
UNASSIGNED: Our results suggested that a combination of PT-Cy, tacrolimus, and low-dose post-engraftment ATG was a promising GVHD prophylaxis with low incidence of acute GVHD in the haplo-transplantation setting.
摘要：
■移植后环磷酰胺（PT-Cy）的使用是最近的移植物抗宿主病（GVHD）预防策略，适用于接受异基因干细胞移植（allo-HSCT）的患者。PT-Cy与两种免疫抑制剂的组合现在在单倍相合（haplo）和HLA匹配的外周血干细胞（PBSC）移植后被广泛使用，具有有希望的GVHD和无复发生存（GRFS）概率。虽然吸引人，这些结果可能受益于显著改善匹配的同胞移植外，应该在不同种族人群中进行调查。
■因此，我们报告了在来自单plo相同供体(Haplo)的异基因干细胞移植中,PT-Cy和他克莫司联合移植后低剂量抗胸腺细胞球蛋白(ATG)的GVHD预防方案的经验.67名患者被纳入分析。所有患者均接受清髓性或强化序贯预处理方案。
■中位随访时间为521（范围，10~991)天。100天II-IV级急性GVHD的累积发生率为14.9±4.4％，无III-IV级急性GVHD病例记录.2年慢性GVHD和中重度慢性GVHD的累积发病率分别为25.4±5.4%和11.9±4%,分别。第100天和第2年的非复发死亡率分别为7.5±3.2％和9.0±3.5％，分别。2年累积复发率为16±6.4%。DFS和OS的2年概率分别为73.8%(95CI,61.5~88.4%)和72.5%(95%CI,57.1~92.1%),分别。2年GRFS估计为63.6%(95CI,50.6~80%)。
■我们的结果表明，PT-Cy的组合，他克莫司,低剂量移植后ATG是一种有前景的GVHD预防方法,在单倍体移植环境中急性GVHD发生率低.
■因此，我们报告了在来自单plo相同供体(Haplo)的异基因干细胞移植中,PT-Cy和他克莫司联合移植后低剂量抗胸腺细胞球蛋白(ATG)的GVHD预防方案的经验.67名患者被纳入分析。所有患者均接受清髓性或强化序贯预处理方案。
■中位随访时间为521（范围，10~991)天。100天II-IV级急性GVHD的累积发生率为14.9±4.4％，无III-IV级急性GVHD病例记录.2年慢性GVHD和中重度慢性GVHD的累积发病率分别为25.4±5.4%和11.9±4%,分别。第100天和第2年的非复发死亡率分别为7.5±3.2％和9.0±3.5％，分别。2年累积复发率为16±6.4%。DFS和OS的2年概率分别为73.8%(95CI,61.5~88.4%)和72.5%(95%CI,57.1~92.1%),分别。2年GRFS估计为63.6%(95CI,50.6~80%)。
■我们的结果表明，PT-Cy的组合，他克莫司,低剂量移植后ATG是一种有前景的GVHD预防方法,在单倍体移植环境中急性GVHD发生率低.
