Impact of post-transplant cyclophosphamide (PTCy)-based prophylaxis in matched sibling donor allogeneic haematopoietic cell transplantation for patients with myelodysplastic syndrome: a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT

María Queralt Salas, Diderik Jan Eikema, Linda Koster, Johan Maertens, Jakob Passweg, Jürgen Finke, Annoek E.C. Broers, Yener Koc, Nicolaus Kröger, Zubeyde Nur Ozkurt, María Jesús Pascual-Cascon, Uwe Platzbecker, Gwendolyn Van Gorkom, Thomas Schroeder, José Luis López-Lorenzo, Massimo Martino, Patrizia Chiusolo, Martin Kaufmann, Francesco Onida, Carmelo GurnariChristof Scheid, Joanna Drozd-Sokolowska, Kavita Raj, Marie Robin, Donal P. McLornan*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

We retrospectively compared outcomes of 404 MDS patients undergoing 1st matched sibling donor allo-HCT receiving either PTCy-based (n = 66) or other “conventional prophylaxis” (n = 338; mostly calcineurin inhibitor + methotrexate or MMF). Baseline characteristics were balanced, except for higher use of myeloablative regimens in the PTCy group (52.3% vs. 38.2%, p = 0.047). Incidences of neutrophil (Day +28: 89% vs. 97%, p = 0.011) and platelet (Day +100: 89% vs. 97%, p < 0.001) engraftment were lower for PTCy-based. Day +100 cumulative incidences of grade II–IV and III–IV aGVHD, and 5-year CI of extensive cGVHD were 32%, 18% and 18% for PTCy-based and 25% (p = 0.3), 13% (p = 0.4) and 31% (p = 0.09) for the conventional cohort. Five-year OS (51% vs. 52%, p = 0.6) and GRFS (33% vs. 25%, p = 0.6) were similar between groups. Patients receiving PTCy had a trend to a lower cumulative incidence of relapse (20% vs. 33%, p = 0.06), not confirmed on multivariable analysis (p = 0.3). Although higher NRM rates were observed in patients receiving PTCy (32% vs. 21%, p = 0.02) on univariate analysis, this was not confirmed on multivariate analysis (HR 1.46, p = 0.18), and there was no resultant effect on OS (HR 1.20, p = 0.5). Based on these data, PTCy prophylaxis appears to be an attractive option for patients with MDS undergoing MSD allo-HCT.

Original languageEnglish
Pages (from-to)479-488
Number of pages10
JournalBone Marrow Transplantation
Volume59
Issue number4
DOIs
Publication statusPublished - Apr 2024

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© The Author(s), under exclusive licence to Springer Nature Limited 2024.

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