{Reference Type}: Journal Article
{Title}: Post-transplant cyclophosphamide pharmacokinetics and haploidentical hematopoietic cell transplantation outcomes: an exploratory study.
{Author}: Kasudhan KS;Patil AN;Jandial A;Khadwal A;Prakash G;Jain A;Bhurani D;Ahmed R;Agrawal N;Singh R;Sachdeva MUS;Varma N;Das R;Verma Attri S;Malhotra S;Majhail NS;Malhotra P;Lad DP;
{Journal}: Leuk Lymphoma
{Volume}: 63
{Issue}: 11
{Year}: Nov 2022
暂无{DOI}: 10.1080/10428194.2022.2087067
{Abstract}: Pharmacokinetics of cyclophosphamide has been explored to optimize conditioning dosing. We hypothesized that post-transplant cyclophosphamide (PTCy) metabolite carboxy-ethyl phosphoramide mustard (CEPM) pharmacokinetics might impact haploidentical transplantation (haplo-HCT) outcomes. CEPM area under the curve (AUC0-48) was determined by eleven sampling timepoints on day +3/+4 using LC-MS/MS. The median CEPM AUC0-48 in a cohort of 30 patients was 14.2 (14) mg·hr/L. The incidence of severe chronic graft-versus-host disease (GVHD) (73% vs. 11%, p = 0.02), and GVHD-/relapse-free survival (GRFS) was significantly inferior in the CEPM AUC0-48 < 14 mg·hr/L group (54 days vs. 344 days, p = 0.02). There was, however, no difference in grade III-IV acute GVHD (38% vs. 14%, p = 0.12) and overall survival (295 days vs. not reached, p = 0.2). CEPM AUC0-48, is associated with severe chronic GVHD and GRFS post-haplo-HCT in this exploratory study. There is scope for personalizing day + 4 PTCy dose based on day + 3 CEPM AUC0-8.