Universal posttransplant cyclophosphamide after allogeneic transplant, a retrospective single institution study

Dennis L. Cooper, Jacqueline Manago, Vimal Patel, Dale Schaar, Anne Tyno, Yong Lin, Roger Strair

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The excellent results of posttransplant cyclophosphamide in decreasing graft-versus-host disease (GVHD) after haploidentical (HI) allogeneic transplant have challenged current donor selection algorithms. Patients and methods: We compared outcomes after matched sibling (MSD) versus alternative donor transplant using identical graft-versus-host disease (GVHD) prophylaxis including posttransplant cyclophosphamide (PTCy. Endpoints included engraftment, time outside of the hospital in the first 100 days after transplant, overall survival (OS), non-relapse mortality (NRM) and percentage of patients disease-free and off immunosuppression (DFOI) at one year and at the last follow-up. Results: There were significant differences at baseline between matched donor versus HI donor transplants with higher disease-risk index (DRI), more female-to-male donor recipient pairs and a higher percentage of Black patients in the HI group. Engraftment and time out of the hospital favored MSD and matched unrelated donor transplants. Multivariate analysis showed that high DRI and Black race were associated with decreased survival and Black race was associated with a higher NRM. Conclusions: With the use of PTCy, our results support current donor selection algorithms. The finding of decreased survival and increased NRM in Black patients requires confirmation in a larger number of patients as well as the development of mitigation strategies.

Original languageEnglish (US)
Article number106934
JournalLeukemia Research
Volume122
DOIs
StatePublished - Nov 2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Cancer Research

Keywords

  • Allogeneic
  • Graft-versus-host disease
  • Haploidentical
  • Racial disparities
  • Transplantation

Fingerprint

Dive into the research topics of 'Universal posttransplant cyclophosphamide after allogeneic transplant, a retrospective single institution study'. Together they form a unique fingerprint.

Cite this