Post‐transplant сyclophosphamide after matched donor hematopoietic stem cell transplantation in children with acute leukemia

• DOI: 10.1111/ctr.15181
• Publication Date: 2023-11-03T17:00:04Z
• Authors: Anastasya Svyatos...; Olesya Vladimirov...; Elena Vladimirovn...; Tatiana Alexandro...; Anna Alekseevna O...; Olga Alexandrovna...; Polina Valerievna...; Lubov Alexandrovn...; Zhemal Zarifovna ...; Andrei Vadimovich...; Alexei Borisovich...; Ilya Viktorovich ...; Maria Arkadievna ...; Oleg Valerievich ...; Sergei Nikolaevic...; Ivan Sergeevich M...; Alexander Dmitrie...; Ludmila Stepanovn...
• Keywords: Antimetabolites; Calcineurin Inhibitors; Hematopoietic Stem Cell Transplantation; Graft vs Host Disease; Mycophenolic Acid; 3. Good health; Leukemia, Myeloid, Acute; Acute Disease; Humans; Child; Unrelated Donors; Cyclophosphamide; Immunosuppressive Agents; Retrospective Studies

Abstract Introduction The data on post‐transplant cyclophosphamide (PTCy) in pediatric acute leukemia after matched allo‐HSCT are limited to case series. present study aimed assess the results of PTCy‐based GVHD prophylaxis a large cohort children with allo‐HSCT. Methods A retrospective analysis 190 patients who had first allograft between 2008 and 2020 from sibling donor (MSD) or unrelated (MUD) was carried out. In MSD setting, consisted PTCy alone ( n = 28) for group, calcineurin inhibitor (CNI) ± antimetabolite 30) control group. MUD most group received PTCy+CNI+mycophenolate mofetil 42, 66.7%) PTCy+CNI+sirolimus 12, 19%). All 69) ATG+CNI+antimetabolite. Results After allo‐HSCT, incidences grade III‐IV moderate/severe chronic were significantly lower compared (6.6% vs. 35.0% 12.7% 47.1%, respectively, p < .0001). Five‐year GVHD‐free, relapse‐free survival (GRFS) higher (35.1% 7.3%, At same time, there no significant difference both groups Conclusions leukemia, is feasible effective option that low incidence GVHD. Compared ATG‐based approach, provides better children. MSD, demonstrates comparable effectiveness conventional prophylaxis.