Posttransplant cyclophosphamide versus antithymocyte globulin in patients with cardiovascular comorbidity undergoing allogeneic hematopoietic cell transplantation for acute myeloid leukaemia in first complete remission from unrelated donors: a retrospective matched-pair analysis from the ALWP of the EBMT
Year: 2025
Type: article
Study design: Observational Study
Abstract: We retrospectively analyzed data from the EBMT registry on patients with pretransplant comorbidities associated with cardiovascular risk. Patients who underwent first allogeneic hematopoietic cell transplantation for acute myeloid leukemia in first complete remission between 2010 and 2022 from unrelated donors using post-transplant cyclophosphamide (ptCy) or anti-thymocyte globulin (ATG)-based graft-versus-host disease prophylaxis with a history of cardiac disease, arrhythmia, diabetes, obesity or cerebrovascular disease according to the HCT-specific comorbidity index were included. We performed a matched-pair analysis using a propensity score. After matching, 432 patients were included: 313 in the ATG group and 119 in the ptCy group. At 2 years, overall survival was 67.5% (95% CI 61-73.2) and 68.6% (95% CI 56.7-77.8); leukemia-free survival was 60.4% (95% CI 53.8-66.4) and 62.6% (95% CI 50.4-72.6); relapse incidence was 22.1% (95% CI 17-27.7) and 23.2% (95% CI 14.3-33.4); non-relapse mortality was 17.5% (95% CI 13.1-22.4) and 14.1% (95% CI 7.5-22.8), respectively. In conclusion, our study suggests that the use of ptCY for GVHD prophylaxis in patients with preexisting comorbidities associated with cardiovascular risk yields long-term outcomes comparable to those observed with ATG-based approaches.
Source: Bone Marrow Transplantation
Authors: Jan Vydra, Allain-Thibeault Ferhat, Nicolaus Kröger, Tobias Gedde-Dahl, Matthias Eder, Thomas Schroeder, Urpu Salmenniemi, Régis Peffault de Latour, Jakob Passweg, Ibrahim Yakoub-Agha, Alessandro Rambaldi, Robert Zeiser, Matthias Stelljes, Kristina Carlson, Cristina Castilla-Llorente, Alexandros Spyridonidis, Bipin Savani, Fabio Ciceri, Mohamad Mohty
Institutions: Institute of Haematology and Blood Transfusion, Sorbonne Université, Hôpital Saint-Antoine, European Society for Blood and Marrow Transplantation, Oslo University Hospital, Medizinische Hochschule Hannover, Essen University Hospital, Helsinki University Hospital, Hospital District of Helsinki and Uusimaa, Hôpital Saint-Louis, University Hospital of Basel, Inserm, Université de Lille, Centre Hospitalier Universitaire de Lille, Institute for Translational Research in Inflammation, University of Milan, University of Freiburg, University of Münster, Uppsala University Hospital, Institut Gustave Roussy, University of Patras, Vanderbilt University Medical Center, IRCCS Ospedale San Raffaele
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,990
OpenAlex ID: W4416955119