Post-Transplant Cyclophosphamide-Based GVHD Prophylaxis After Peripheral Blood Stem Cell HLA Identical Transplantation in Patients with Lymphoma: A Prospective Observational Study
Allogeneic stem cell transplantation (allo-SCT) from HLA-identical donors (HLAid) could be an effective salvage treatment for relapsed/refractory lymphoma. In this setting, standard graft-versus-host disease (GVHD) prophylaxis is based on cyclosporine and methotrexate, with the addition of anti-thym...
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2025-03-01
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| author | Stefania Bramanti Daniela Taurino Filippo Magri Chiara De Philippis Barbara Sarina Luca Castagna Laura Giordano Jacopo Mariotti Daniele Mannina Armando Santoro |
| author_facet | Stefania Bramanti Daniela Taurino Filippo Magri Chiara De Philippis Barbara Sarina Luca Castagna Laura Giordano Jacopo Mariotti Daniele Mannina Armando Santoro |
| author_sort | Stefania Bramanti |
| collection | DOAJ |
| description | Allogeneic stem cell transplantation (allo-SCT) from HLA-identical donors (HLAid) could be an effective salvage treatment for relapsed/refractory lymphoma. In this setting, standard graft-versus-host disease (GVHD) prophylaxis is based on cyclosporine and methotrexate, with the addition of anti-thymocyte globulin, at least for matched, unrelated donors. Promising data using post-transplant cyclophosphamide (PT-Cy) have been reported from retrospective studies in patients receiving allo-SCT from HLAid donors. Here, we report the results of a single-center, prospective observational study exploring the main outcomes of GVHD prophylaxis based on PT-Cy in 27 patients receiving HLAid donor transplantation for relapsed/refractory lymphoma. With a median follow-up of 38 months, 3-year GVHD-relapse-free survival and PFS and OS were 70.4%, 81.5%, and 88.9%, respectively. The 1-year cumulative incidence (CI) of non-relapse mortality (NRM) was 7.4%. The 6-month CI of acute GVHD was 7.4%, and the 1-year CI of extensive chronic GVHD was 7.7%, with no grade IV GVHD events or deaths from GVHD. Relapse was reported in three patients (1-year relapse incidence: 11%), and two died of progressive disease. No graft failure was observed. This study shows that PT-Cy may be an effective strategy to prevent GVHD in patients with lymphoma receiving HLAid transplantation. It is associated with low NRM and reasonable disease control. |
| format | Article |
| id | doaj-art-8b0e7b4bbf724b7898450e391d38e075 |
| institution | DOAJ |
| issn | 2075-1729 |
| language | English |
| publishDate | 2025-03-01 |
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| spelling | doaj-art-8b0e7b4bbf724b7898450e391d38e0752025-08-20T02:42:38ZengMDPI AGLife2075-17292025-03-0115339310.3390/life15030393Post-Transplant Cyclophosphamide-Based GVHD Prophylaxis After Peripheral Blood Stem Cell HLA Identical Transplantation in Patients with Lymphoma: A Prospective Observational StudyStefania Bramanti0Daniela Taurino1Filippo Magri2Chiara De Philippis3Barbara Sarina4Luca Castagna5Laura Giordano6Jacopo Mariotti7Daniele Mannina8Armando Santoro9Bone Marrow Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, 20089 Milan, ItalyBone Marrow Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, 20089 Milan, ItalyImmunohematology and Transfusion Medicine Unit, IRCCS San Raffaele Scientific Institute, 20089 Milan, ItalyBone Marrow Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, 20089 Milan, ItalyBone Marrow Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, 20089 Milan, ItalyBone Marrow Unit, Ospedale Villa Sofia Cervello, 90146 Palermo, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, ItalyBone Marrow Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, 20089 Milan, ItalyBone Marrow Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, 20089 Milan, ItalyBone Marrow Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, 20089 Milan, ItalyAllogeneic stem cell transplantation (allo-SCT) from HLA-identical donors (HLAid) could be an effective salvage treatment for relapsed/refractory lymphoma. In this setting, standard graft-versus-host disease (GVHD) prophylaxis is based on cyclosporine and methotrexate, with the addition of anti-thymocyte globulin, at least for matched, unrelated donors. Promising data using post-transplant cyclophosphamide (PT-Cy) have been reported from retrospective studies in patients receiving allo-SCT from HLAid donors. Here, we report the results of a single-center, prospective observational study exploring the main outcomes of GVHD prophylaxis based on PT-Cy in 27 patients receiving HLAid donor transplantation for relapsed/refractory lymphoma. With a median follow-up of 38 months, 3-year GVHD-relapse-free survival and PFS and OS were 70.4%, 81.5%, and 88.9%, respectively. The 1-year cumulative incidence (CI) of non-relapse mortality (NRM) was 7.4%. The 6-month CI of acute GVHD was 7.4%, and the 1-year CI of extensive chronic GVHD was 7.7%, with no grade IV GVHD events or deaths from GVHD. Relapse was reported in three patients (1-year relapse incidence: 11%), and two died of progressive disease. No graft failure was observed. This study shows that PT-Cy may be an effective strategy to prevent GVHD in patients with lymphoma receiving HLAid transplantation. It is associated with low NRM and reasonable disease control.https://www.mdpi.com/2075-1729/15/3/393allo-SCTGVHDprophylaxiscyclophosphamidelymphoma |
| spellingShingle | Stefania Bramanti Daniela Taurino Filippo Magri Chiara De Philippis Barbara Sarina Luca Castagna Laura Giordano Jacopo Mariotti Daniele Mannina Armando Santoro Post-Transplant Cyclophosphamide-Based GVHD Prophylaxis After Peripheral Blood Stem Cell HLA Identical Transplantation in Patients with Lymphoma: A Prospective Observational Study Life allo-SCT GVHD prophylaxis cyclophosphamide lymphoma |
| title | Post-Transplant Cyclophosphamide-Based GVHD Prophylaxis After Peripheral Blood Stem Cell HLA Identical Transplantation in Patients with Lymphoma: A Prospective Observational Study |
| title_full | Post-Transplant Cyclophosphamide-Based GVHD Prophylaxis After Peripheral Blood Stem Cell HLA Identical Transplantation in Patients with Lymphoma: A Prospective Observational Study |
| title_fullStr | Post-Transplant Cyclophosphamide-Based GVHD Prophylaxis After Peripheral Blood Stem Cell HLA Identical Transplantation in Patients with Lymphoma: A Prospective Observational Study |
| title_full_unstemmed | Post-Transplant Cyclophosphamide-Based GVHD Prophylaxis After Peripheral Blood Stem Cell HLA Identical Transplantation in Patients with Lymphoma: A Prospective Observational Study |
| title_short | Post-Transplant Cyclophosphamide-Based GVHD Prophylaxis After Peripheral Blood Stem Cell HLA Identical Transplantation in Patients with Lymphoma: A Prospective Observational Study |
| title_sort | post transplant cyclophosphamide based gvhd prophylaxis after peripheral blood stem cell hla identical transplantation in patients with lymphoma a prospective observational study |
| topic | allo-SCT GVHD prophylaxis cyclophosphamide lymphoma |
| url | https://www.mdpi.com/2075-1729/15/3/393 |
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