The efficacy of the regimens of “graft versus host” disease prophylaxis after hematopoietic stem cell transplantation from unrelated donors in children: single center experience

• DOI: 10.24287/1726-1708-2020-19-2-71-82
• Publication Date: 2020-07-04T07:18:45Z
• Authors: N. V. Sidorova; A. S. Slinin; E. B. Machneva; V. V. Konstantinova; A. E. Burya; E. A. Pristanskova; O. L. Lagonravova; E. V. Skorobogatovа; K. I. Kirgizov
• Keywords: Mucositis; Regimen

Graft versus host” disease (GvHD) is one of the most frequent and severe complications allogeneic hematopoietic stem cell transplantation (allo-HSCT). The optimal model GvHD prophylaxis in allo-HSCT from alternative donors children currently remains actual question. Materials methods. study was approved by Independent Ethics Committee Scientific Council N.N. Blokhin National Medical Research Center Oncology, Ministry Healthcare Russian Federation. Two hundred fifty six were made during period 2003–2019 matched unrelated (MUD). Age median 7.1 years old. source cells (HSCs) bone marrow – 76% (n = 194), peripheral blood 24% 62). included: tacrolimus (Tacro), cyclosporin A (CsA), methotrexate (Mtx), mycophenolate mofetil (MMF), following combinations Tacro/Mtx 98), Tacro/MMF 102), tacro/Mtx + MMF 3), CsA/Mtx 24), 12), CsA 14). Median follow-up 8.9 years. regimen did not affect significantly toxicity therapy (toxicity: mucositis grade III–IV, nephrotoxicity, hepatotoxicity) (p 0.4; p 0.24; 0.62 respectively). In our rate overall survival (ОS) has significant differences depending prevention GvHD. using a combination cyclosporine with low doses had positive effect on OS 0.035) patients common non-malignant malignant groups, as well level 2-year relapse-free group disorders 0.671). general worst results achieved when included model. this experience treating large cohort choice calcineurin inhibitors agent showed efficacy safety for non-manipulated MUD both diseases children.