In a nutshell
This study aimed to investigate post-transplant cyclophosphamide treatment in patients with acute myeloid leukemia. This study concluded that this treatment is safe and effective in these patients.
Some background
Post-transplant cyclophosphamide (PTCy) is an immune system suppressant. It can be used after stem cell transplant (SCT) to prevent graft-versus-host-disease (GVHD). GVHD is a side effect of SCT where the transplanted cells attack the patients. PTCy is being used in cases of matched sibling (MSD) and matched unrelated (MUD) donor transplants.
It is unknown if the donor type has an impact on the use of PTCy.
Methods & findings
This study involved adult patients with acute myeloid leukemia (AML) in first complete remission (CR1). Patients received allogeneic (donor) stem cell transplant (SCT) with PTCy. 215 patients received cells from MSD. 235 patients received cells from MUD and 789 from a haploidentical (half-matched) donor. Patients were followed for an average of 2 years.
Haploidentical SCT had 1.6 times higher risk of short-term GVHD compared to MSD. It also had a 2.6 higher risk of non-relapse mortality (NRM). However, haploidentical SCT had a 30% lower risk of relapse than MSD.
The use of peripheral blood was associated with increased risk of short-term and long-term GVHD. The use of peripheral blood was associated with a lower risk of relapse.
Survival without leukemia and overall survival rates were similar between the 3 groups.
The bottom line
This study concluded that the use of PTCy in patients with AML in CR1 receiving SCT from MSD, MUD and haploidentical donors is safe and effective. It was also concluded that haploidentical SCT had increased risk of short-term GVHD and NRM and lower relapse risk but no significant difference in survival.
The fine print
This study was based on medical records. Information might have been missing. This might have influenced the results.
Published By :
Journal of hematology & oncology
Date :
May 06, 2020
