TY - JOUR
T1 - PTCy vs CNI–based GVHD prophylaxis in HLA-matched transplants for Hodgkin lymphoma
T2 - a study of the LWP of the EBMT
AU - Montoro, Juan
AU - Ngoya, Maud
AU - Kulagin, Alexander
AU - Giebel, Sebastian
AU - Broers, Annoek E.C.
AU - Bramanti, Stefania
AU - Halahleh, Khalid
AU - Pérez-Simón, Jose A.
AU - Solano, Carlos
AU - Ozcelik, Tulay
AU - Blaise, Didier
AU - Sanz, Jaime
AU - Henriques, Marta
AU - de Latour, Régis Peffault
AU - Martino, Rodrigo
AU - Scheid, Christof
AU - Fox, Laura
AU - Gromek, Tomasz
AU - Jurado, Manuel
AU - Sakellari, Ioanna
AU - Van Gorkom, Gwendolyn
AU - Matteucci, Paola
AU - Nagler, Arnon
AU - Koc, Yener
AU - Glass, Bertram
N1 - Publisher Copyright:
© 2024 by The American Society of Hematology.
PY - 2024/8/13
Y1 - 2024/8/13
N2 - Studies comparing the efficacy of posttransplant cyclophosphamide (PTCy) to conventional calcineurin inhibitor (CNI)–based graft-versus-host disease (GVHD) prophylaxis regimens in patients with Hodgkin lymphoma (HL) are scarce. This study aimed to compare the outcomes of patients with HL undergoing hematopoietic stem cell transplantation (HSCT) from HLA-matched donors who received GVHD prophylaxis with either PTCy- or conventional CNI-based regimens, using data reported in the European Society for Blood and Marrow Transplantation database between January 2015 and December 2022. Among the cohort, 270 recipients received conventional CNI-based prophylaxis and 176 received PTCy prophylaxis. Notably, PTCy prophylaxis was associated with delayed hematopoietic recovery but also with a lower risk of chronic (25% vs 43%; P < .001) and extensive chronic GVHD (13% vs 28%; P = .003) compared with the CNI-based cohort. The 2-year cumulative incidence of nonrelapse mortality and relapse was 11% vs 17% (P = .12) and 17% vs 30% (P = .007) for PTCy- and CNI-based, respectively. Moreover, the 2-year overall survival (OS), progression-free survival (PFS), and GVHD-free, relapse-free survival (GRFS) were all significantly better in the PTCy group compared with the CNI-based group: 85% vs 72% (P = .005), 72% vs 53% (P < .001), and 59% vs 31% (P < .001), respectively. In multivariable analysis, PTCy was associated with a lower risk of chronic and extensive chronic GVHD, reduced relapse, and better OS, PFS, and GRFS than the CNI-based platform. Our findings suggest that PTCy as GVHD prophylaxis offers more favorable outcomes than conventional CNI-based prophylaxis in adult patients with HL undergoing HSCT from HLA-matched donors.
AB - Studies comparing the efficacy of posttransplant cyclophosphamide (PTCy) to conventional calcineurin inhibitor (CNI)–based graft-versus-host disease (GVHD) prophylaxis regimens in patients with Hodgkin lymphoma (HL) are scarce. This study aimed to compare the outcomes of patients with HL undergoing hematopoietic stem cell transplantation (HSCT) from HLA-matched donors who received GVHD prophylaxis with either PTCy- or conventional CNI-based regimens, using data reported in the European Society for Blood and Marrow Transplantation database between January 2015 and December 2022. Among the cohort, 270 recipients received conventional CNI-based prophylaxis and 176 received PTCy prophylaxis. Notably, PTCy prophylaxis was associated with delayed hematopoietic recovery but also with a lower risk of chronic (25% vs 43%; P < .001) and extensive chronic GVHD (13% vs 28%; P = .003) compared with the CNI-based cohort. The 2-year cumulative incidence of nonrelapse mortality and relapse was 11% vs 17% (P = .12) and 17% vs 30% (P = .007) for PTCy- and CNI-based, respectively. Moreover, the 2-year overall survival (OS), progression-free survival (PFS), and GVHD-free, relapse-free survival (GRFS) were all significantly better in the PTCy group compared with the CNI-based group: 85% vs 72% (P = .005), 72% vs 53% (P < .001), and 59% vs 31% (P < .001), respectively. In multivariable analysis, PTCy was associated with a lower risk of chronic and extensive chronic GVHD, reduced relapse, and better OS, PFS, and GRFS than the CNI-based platform. Our findings suggest that PTCy as GVHD prophylaxis offers more favorable outcomes than conventional CNI-based prophylaxis in adult patients with HL undergoing HSCT from HLA-matched donors.
UR - http://www.scopus.com/inward/record.url?scp=85201479742&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2024013328
DO - 10.1182/bloodadvances.2024013328
M3 - Article
C2 - 38810260
AN - SCOPUS:85201479742
SN - 2473-9529
VL - 8
SP - 3985
EP - 3992
JO - Blood Advances
JF - Blood Advances
IS - 15
ER -