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Reduced intensity allogeneic stem cell transplant with anti‐thymocyte globulin and post‐transplant cyclophosphamide in acute myeloid leukemia
Author(s) -
Salas Maria Queralt,
Prem Shruti,
Atenafu Eshetu G.,
Law Arjun Datt,
Lam Wilson,
AlShaibani Zeyad,
Loach David,
Kim Dennis Dong Hwan,
Michelis Fotios V.,
Lipton Jeffrey Howard,
Kumar Rajat,
Mattsson Jonas,
Viswabandya Auro
Publication year - 2019
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13321
Subject(s) - medicine , cumulative incidence , anti thymocyte globulin , cyclophosphamide , gastroenterology , incidence (geometry) , hematopoietic stem cell transplantation , myeloid leukemia , graft versus host disease , surgery , globulin , immunology , transplantation , chemotherapy , physics , optics
Objectives We aimed to study the efficacy of reduced intensity conditioning (RIC) allo‐HSCT combined with anti‐thymocyte globulin (ATG) and post‐transplant cyclophosphamide (PTCy) for graft‐versus‐host disease (GVHD) prophylaxis in AML. Methods One hundred forty‐seven patients were included. All patients underwent unmanipulated peripheral blood stem cell RIC allo‐HSCT. Median follow‐up was 12.8 months (range 0.5‐39). Results Median age was 58 years. Twenty‐nine (20%) recipients received 10/10 MRD grafts, 69 (47%) 10/10 MUD grafts, 20 (13.6%) 9/10 MMUD, and 29 (20%) haploidentical grafts. The cumulative incidence of grade II‐IV and III‐IV acute GVHD at day +100, and moderate/severe chronic GVHD at 1‐year were as follow: 14.3%, 1.4%, and 8.3%. There were no significant differences according to donor type ( P = .46) and cumulative incidence of GVHD. One‐year overall survival (OS), relapse‐free survival (RFS), non‐relapse mortality, and GVHD‐free/Relapse‐free survival were as follows: 66.9% (95% CI 58.4‐74), 59.9%, and 18.7% and 53.7%. KPS ≤ 80 was predictive of worst OS ( P = .04). Those recipients who received MUD transplants had better RFS ( P = .01). Conclusions RIC allo‐HSCT combined with ATG and PTCy is safe and a potentially curative strategy and it is associated with impressive GRFS in AML.