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Transplantation Technologies & Research

Transplantation Technologies & Research

ISSN: 2161-0991

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Post-transplant high-dose cyclophosphamide (PTCy) effectively prevents GvHD after haplo-identical TSS. However, its use in the SCT corresponding to HLA has been less explored. Fifty-six consecutive patients who underwent allo-SCT for hematological malignancies were included in this prospective monocentric protocol. The donors were identical HLA siblings, unrelated wholly related or non-allelic 1-allele donors in 30%, 32% and 37% of cases, respectively. Nine patients received a MAC regimen containing TBI, while the rest (84%) received RIC platforms based on Fludarabine plus Busulfan / Melphalan. Due to the high rate of transplant failure (GF) (21%) in a preliminary analysis in the allo-RIC cohort (n = 29), protocol modifications were implemented, with no other case of GF after l introduction of mini-thiotépa (0/18). The overall incidence of acute grade II - IV GvHD is 24% (95% CI: 17–31%) with four cases of refractory steroids. Severe chronic GvHD only occurred in 1 of 43 evaluable cases. The 1-year NRM and relapse are 18% (95% CI: 12–26%) and 30% (18–42%) and the OS and DFS are 78% and 64%, respectively. These results confirm the feasibility of using PTCy as SOC outside the haplo framework, although mini-thiotepa (3 mg / kg) has been incorporated into standard allo-RIC platforms to prevent FM. Despite the limits of a monocentric experiment and the short follow-up, these protocols show promising results with a particular advantage in reducing the occurrence of moderate to severe GvHD.

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Citations: 223

Transplantation Technologies & Research received 223 citations as per Google Scholar report

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