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Post-transplant cyclophosphamide for GVHD prophylaxis compared to ATG-based prophylaxis in unrelated donor transplantation

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Abstract

Post-transplant cyclophosphamide (PTCY) effectively prevents graft-versus-host disease after unmanipulated HLA-haploidentical HSCT. The use of PTCY in the unrelated donor HSCT setting is less explored. We conducted a retrospective study of 132 consecutive patients undergoing a matched or 9/10 mismatched unrelated donor HSCT in 4 centers in Spain, 60 with anti-thymocyte globulin (ATG)-based prophylaxis combined with MTX-CsA, and 72 using a PTCY-based regimen. Peripheral blood stem cells were used as graft in most patients (111 patients, 84%); mMUD donors were balanced between groups. Cumulative incidences of grades II–IV and III–IV acute GVHD at 100 days were lower in the PTCy group (46% vs. 67%, p = 0.008; 3% vs. 34%, p = 0.003), without statistically significant differences in the 2-year cumulative incidence of chronic moderate-severe GVHD. At 2 years, no significant differences were observed in overall survival, event-free survival, cumulative incidence of relapse, and non-relapse mortality. GVHD was the most frequent cause of NRM in the ATG group. No differences were observed between groups in the composite endpoint of GVHD-free and relapse-free survival. In this study, PTCy combined with additional immunosuppression after MUD/mMUD HSCT showed a reduction of aGVHD rate with safety results comparable to those obtained with the ATG-based prophylaxis.

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References

  1. Pidala J, Kurland B, Chai X, Majhail N, Weisdorf DJ, Pavletic S, Cutler C, Jacobsohn D, Palmer J, Arai S, Jagasia M, Lee SJ (2011) Patient-reported quality of life is associated with severity of chronic graft-versus-host disease as measured by NIH criteria: report on baseline data from the Chronic GVHD Consortium. Blood 117:4651–4657. https://doi.org/10.1182/blood-2010-11-319509

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Boyiadzis M, Arora M, Klein JP, Hassebroek A, Hemmer M, Urbano-Ispizua A, Antin JH, Bolwell BJ, Cahn JYY, Cairo MS, Cutler CS, Flowers ME, Gale RP, Herzig R, Isola LM, Jacobsohn DA, Jagasia MH, Klumpp TR, Lee SJ, Petersdorf EW, Santarone S, Spellman SR, Schouten HC, Verdonck LF, Wingard JR, Weisdorf DJ, Horowitz MM, Pavletic SZ (2015) Impact of chronic graft-versus-host disease on late relapse and survival on 7,489 patients after myeloablative allogeneic hematopoietic cell transplantation for leukemia. Clin Cancer Res 21:2020–2028. https://doi.org/10.1158/1078-0432.CCR-14-0586

    Article  PubMed  Google Scholar 

  3. Storb R, Deeg HJ, Whitehead J, Appelbaum F, Beatty P, Bensinger W, Buckner CD, Clift R, Doney K, Farewell V, Hansen J, Hill R, Lum L, Martin P, McGuffin R, Sanders J, Stewart P, Sullivan K, Witherspoon R, Yee G, Thomas ED (1986) Methotrexate and cyclosporine compared with cyclosporine alone for prophylaxis of acute graft versus host disease after marrow transplantation for leukemia. N Engl J Med 314:729–735. https://doi.org/10.1056/NEJM198603203141201

    Article  CAS  PubMed  Google Scholar 

  4. Ruutu T, Gratwohl A, de WT et al (2014) Prophylaxis and treatment of GVHD: EBMT–ELN working group recommendations for a standardized practice. Bone Marrow Transplant 49:168–173. https://doi.org/10.1038/bmt.2013.107

    Article  CAS  PubMed  Google Scholar 

  5. Bacigalupo A, Lamparelli T, Barisione G, Bruzzi P, Guidi S, Alessandrino PE, di Bartolomeo P, Oneto R, Bruno B, Sacchi N, van Lint M, Bosi A, Gruppo Italiano Trapianti Midollo Osseo (GITMO) (2006) Thymoglobulin prevents chronic graft-versus-host disease, chronic lung dysfunction, and late transplant-related mortality: long-term follow-up of a randomized trial in patients undergoing unrelated donor transplantation. Biol Blood Marrow Transplant 12:560–565. https://doi.org/10.1016/j.bbmt.2005.12.034

    Article  PubMed  Google Scholar 

  6. Finke J, Bethge WA, Schmoor C, Ottinger HD, Stelljes M, Zander AR, Volin L, Ruutu T, Heim DA, Schwerdtfeger R, Kolbe K, Mayer J, Maertens JA, Linkesch W, Holler E, Koza V, Bornhäuser M, Einsele H, Kolb HJ, Bertz H, Egger M, Grishina O, Socié G (2009) Standard graft-versus-host disease prophylaxis with or without anti-T-cell globulin in haematopoietic cell transplantation from matched unrelated donors: a randomised, open-label, multicentre phase 3 trial. Lancet Oncol 10:855–864. https://doi.org/10.1016/S1470-2045(09)70225-6

    Article  CAS  PubMed  Google Scholar 

  7. Penack O, Marchetti M, Ruutu T, Aljurf M, Bacigalupo A, Bonifazi F, Ciceri F, Cornelissen J, Malladi R, Duarte RF, Giebel S, Greinix H, Holler E, Lawitschka A, Mielke S, Mohty M, Arat M, Nagler A, Passweg J, Schoemans H, Socié G, Solano C, Vrhovac R, Zeiser R, Kröger N, Basak GW (2020) Prophylaxis and management of graft versus host disease after stem-cell transplantation for haematological malignancies: updated consensus recommendations of the European Society for Blood and Marrow Transplantation. Lancet Haematol 7:e157–e167. https://doi.org/10.1016/S2352-3026(19)30256-X

    Article  PubMed  Google Scholar 

  8. Soiffer RJ, LeRademacher J, Ho V, Kan F, Artz A, Champlin RE, Devine S, Isola L, Lazarus HM, Marks DI, Porter DL, Waller EK, Horowitz MM, Eapen M (2011) Impact of immune modulation with anti–T-cell antibodies on the outcome of reduced-intensity allogeneic hematopoietic stem cell transplantation for hematologic malignancies. Blood 117:6963–6970. https://doi.org/10.1182/blood-2011-01-332007

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Baron F, Labopin M, Blaise D, Lopez-Corral L, Vigouroux S, Craddock C, Attal M, Jindra P, Goker H, Socié G, Chevallier P, Browne P, Sandstedt A, Duarte RF, Nagler A, Mohty M (2014) Impact of in vivo T-cell depletion on outcome of AML patients in first CR given peripheral blood stem cells and reduced-intensity conditioning allo-SCT from a HLA-identical sibling donor: a report from the Acute Leukemia Working Party of the European group for Blood and Marrow Transplantation. Bone Marrow Transplant 49:389–396. https://doi.org/10.1038/bmt.2013.204

    Article  CAS  PubMed  Google Scholar 

  10. Admiraal R, Nierkens S, de Witte MA, Petersen EJ, Fleurke GJ, Verrest L, Belitser SV, Bredius RGM, Raymakers RAP, Knibbe CAJ, Minnema MC, van Kesteren C, Kuball J, Boelens JJ (2017) Association between anti-thymocyte globulin exposure and survival outcomes in adult unrelated haemopoietic cell transplantation: a retrospective, pharmacodynamic cohort analysis. Lancet Haematol 4:e183–e191. https://doi.org/10.1016/S2352-3026(17)30029-7

    Article  PubMed  Google Scholar 

  11. Soiffer RJ, Kim HT, McGuirk J et al (2017) Prospective, randomized, double-blind, phase III clinical trial of anti–T-lymphocyte globulin to assess impact on chronic graft-versus-host disease–free survival in patients undergoing HLA-matched unrelated myeloablative hematopoietic cell transplantation. JCO 35:4003–4011. https://doi.org/10.1200/JCO.2017.75.8177

    Article  CAS  Google Scholar 

  12. Luznik L, O’Donnell PV, Symons HJ et al (2008) HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide. Biol Blood Marrow Transplant 14:641–650. https://doi.org/10.1016/j.bbmt.2008.03.005

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Luznik L, Bolaños-Meade J, Zahurak M, Chen AR, Smith BD, Brodsky R, Huff CA, Borrello I, Matsui W, Powell JD, Kasamon Y, Goodman SN, Hess A, Levitsky HI, Ambinder RF, Jones RJ, Fuchs EJ (2010) High-dose cyclophosphamide as single-agent, short-course prophylaxis of graft-versus-host disease. Blood 115:3224–3230. https://doi.org/10.1182/blood-2009-11-251595

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Kanakry CG, O’Donnell PV, Furlong T et al (2014) Multi-institutional study of post-transplantation cyclophosphamide as single-agent graft-versus-host disease prophylaxis after allogeneic bone Marrow transplantation using myeloablative busulfan and fludarabine conditioning. J Clin Oncol 32:3497–3505. https://doi.org/10.1200/JCO.2013.54.0625

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Bradstock KF, Bilmon I, Kwan J, Micklethwaite K, Blyth E, Deren S, Bayley A, Gebski V, Gottlieb D (2015) Single-gent high-dose cyclophosphamide for graft-versus-host disease prophylaxis in human leukocyte antigen–matched reduced-intensity peripheral blood stem cell transplantation results in an unacceptably high rate of severe acute graft-versus-host disease. Biol Blood Marrow Transplant 21:941–944. https://doi.org/10.1016/j.bbmt.2015.01.020

    Article  CAS  PubMed  Google Scholar 

  16. Holtick U, Chemnitz J-M, Shimabukuro-Vornhagen A, Theurich S, Chakupurakal G, Krause A, Fiedler A, Luznik L, Hellmich M, Wolf D, Hallek M, von Bergwelt-Baildon M, Scheid C (2016) OCTET-CY: a phase II study to investigate the efficacy of post-transplant cyclophosphamide as sole graft-versus-host prophylaxis after allogeneic peripheral blood stem cell transplantation. Eur J Haematol 96:27–35. https://doi.org/10.1111/ejh.12541

    Article  CAS  PubMed  Google Scholar 

  17. Mielcarek M, Furlong T, O’Donnell PV, Storer BE, McCune JS, Storb R, Carpenter PA, Flowers MED, Appelbaum FR, Martin PJ (2016) Posttransplantation cyclophosphamide for prevention of graft-versus-host disease after HLA-matched mobilized blood cell transplantation. Blood 127:1502–1508. https://doi.org/10.1182/blood-2015-10-672071

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Ruggeri A, Labopin M, Bacigalupo A, Afanasyev B, Cornelissen JJ, Elmaagacli A, Itälä-Remes M, Blaise D, Meijer E, Koc Y, Milpied N, Schouten HC, Kroeger N, Mohty M, Nagler A (2018) Post-transplant cyclophosphamide for graft-versus-host disease prophylaxis in HLA matched sibling or matched unrelated donor transplant for patients with acute leukemia, on behalf of ALWP-EBMT. J Hematol Oncol 11:40. https://doi.org/10.1186/s13045-018-0586-4

    Article  PubMed  PubMed Central  Google Scholar 

  19. Moiseev IS, Pirogova OV, Alyanski AL, Babenko EV, Gindina TL, Darskaya EI, Slesarchuk OA, Bondarenko SN, Afanasyev BV (2016) Graft-versus-host disease prophylaxis in unrelated peripheral blood stem cell transplantation with post-transplantation cyclophosphamide, tacrolimus, and mycophenolate mofetil. Biol Blood Marrow Transplant 22:1037–1042. https://doi.org/10.1016/j.bbmt.2016.03.004

    Article  CAS  PubMed  Google Scholar 

  20. Kwon M, Bailén R, Pascual-Cascón MJ, Gallardo-Morillo AI, García Sola A, Balsalobre P, Solán L, Dorado N, Muñoz C, Serrano D, Martínez-Laperche C, Buño I, Anguita J, Díez-Martin JL (2019) Posttransplant cyclophosphamide vs cyclosporin A and methotrexate as GVHD prophylaxis in matched sibling transplantation. Blood Adv 3:3351–3359. https://doi.org/10.1182/bloodadvances.2019000236

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Shah MV, Saliba RM, Rondon G, Chen J, Soebbing D, Rus I, Alousi A, Oran B, Kebriaei P, Qazilbash M, Parmar S, Hosing C, Khouri IF, Popat UR, Champlin RE, Ciurea SO (2019) Pilot study using post-transplant cyclophosphamide (PTCy), tacrolimus and mycophenolate GVHD prophylaxis for older patients receiving 10/10 HLA-matched unrelated donor hematopoietic stem cell transplantation. Bone Marrow Transplant 54:601–606. https://doi.org/10.1038/s41409-018-0367-2

    Article  CAS  PubMed  Google Scholar 

  22. Battipaglia G, Labopin M, Kröger N, Vitek A, Afanasyev B, Hilgendorf I, Schetelig J, Ganser A, Blaise D, Itälä-Remes M, Passweg JR, Bonifazi F, Finke J, Ruggeri A, Nagler A, Mohty M (2019) Posttransplant cyclophosphamide vs antithymocyte globulin in HLA-mismatched unrelated donor transplantation. Blood 134:892–899. https://doi.org/10.1182/blood.2019000487

    Article  CAS  PubMed  Google Scholar 

  23. De Jong C, Meijer E, Bakunina K (2019) Post-transplantation cyclophosphamide after allogeneic hematopoietic stem cell transplantation: results of the prospective randomized HOVON-96 trial in recipients of matched related and unrelated fonors. ASH meeting 2019 (Orlando)

  24. Howard CA, Fernandez-Vina MA, Appelbaum FR, Confer DL, Devine SM, Horowitz MM, Mendizabal A, Laport GG, Pasquini MC, Spellman SR (2015) Recommendations for donor human leukocyte antigen assessment and matching for allogeneic stem cell transplantation: consensus opinion of the blood and marrow transplant clinical trials network (BMT CTN). Biol Blood Marrow Transplant 21:4–7. https://doi.org/10.1016/j.bbmt.2014.09.017

    Article  PubMed  Google Scholar 

  25. Armand P, Kim HT, Logan BR, et al (2014) Validation and refinement of the disease risk index for allogeneic stem cell transplantation: a study from the CIBMTR. Blood blood-2014-01-552984. https://doi.org/10.1182/blood-2014-01-552984

  26. Sorror ML, Storb RF, Sandmaier BM et al (2014) Comorbidity-age index: a clinical measure of biologic age before allogeneic hematopoietic cell transplantation. JCO 32:3249–3256. https://doi.org/10.1200/JCO.2013.53.8157

    Article  Google Scholar 

  27. Buño I, Nava P, Simón A, González-Rivera M, Jiménez JL, Balsalobre P, Serrano D, Carrión R, Gómez-Pineda A, Díez-Martín JL (2005) A comparison of fluorescent in situ hybridization and multiplex short tandem repeat polymerase chain reaction for quantifying chimerism after stem cell transplantation. Haematologica 90:1373–1379

    PubMed  Google Scholar 

  28. Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J, Thomas ED (1995) 1994 Consensus conference on acute GVHD grading. Bone Marrow Transplant 15:825–828

    CAS  PubMed  Google Scholar 

  29. Jagasia MH, Greinix HT, Arora M et al (2015) National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and Staging Working Group Report. Biol Blood Marrow Transplant 21:389–401.e1. https://doi.org/10.1016/j.bbmt.2014.12.001

    Article  PubMed  Google Scholar 

  30. Ruggeri A, Labopin M, Ciceri F, Mohty M, Nagler A (2016) Definition of GvHD-free, relapse-free survival for registry-based studies: an ALWP-EBMT analysis on patients with AML in remission. Bone Marrow Transplant 51:610–611. https://doi.org/10.1038/bmt.2015.305

    Article  CAS  PubMed  Google Scholar 

  31. Gooley TA, Leisenring W, Crowley J, Storer BE (1999) Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Stat Med 18:695–706

    Article  CAS  Google Scholar 

  32. Kröger N, Solano C, Wolschke C, Bandini G, Patriarca F, Pini M, Nagler A, Selleri C, Risitano A, Messina G, Bethge W, Pérez de Oteiza J, Duarte R, Carella AM, Cimminiello M, Guidi S, Finke J, Mordini N, Ferra C, Sierra J, Russo D, Petrini M, Milone G, Benedetti F, Heinzelmann M, Pastore D, Jurado M, Terruzzi E, Narni F, Völp A, Ayuk F, Ruutu T, Bonifazi F (2016) Antilymphocyte globulin for prevention of chronic graft-versus-host disease. N Engl J Med 374:43–53. https://doi.org/10.1056/NEJMoa1506002

    Article  CAS  PubMed  Google Scholar 

  33. Walker I, Panzarella T, Couban S, Couture F, Devins G, Elemary M, Gallagher G, Kerr H, Kuruvilla J, Lee SJ, Moore J, Nevill T, Popradi G, Roy J, Schultz KR, Szwajcer D, Toze C, Foley R (2016) Pretreatment with anti-thymocyte globulin versus no anti-thymocyte globulin in patients with haematological malignancies undergoing haemopoietic cell transplantation from unrelated donors: a randomised, controlled, open-label, phase 3, multicentre trial. Lancet Oncol 17:164–173. https://doi.org/10.1016/S1470-2045(15)00462-3

    Article  CAS  PubMed  Google Scholar 

  34. Carnevale-Schianca F, Caravelli D, Gallo S, Coha V, D'Ambrosio L, Vassallo E, Fizzotti M, Nesi F, Gioeni L, Berger M, Polo A, Gammaitoni L, Becco P, Giraudo L, Mangioni M, Sangiolo D, Grignani G, Rota–Scalabrini D, Sottile A, Fagioli F, Aglietta M (2017) Post-transplant cyclophosphamide and tacrolimus–mycophenolate mofetil combination prevents graft-versus-host fisease in allogeneic peripheral blood hematopoietic cell transplantation from HLA-matched donors. Biol Blood Marrow Transplant 23:459–466. https://doi.org/10.1016/j.bbmt.2016.12.636

    Article  CAS  PubMed  Google Scholar 

  35. Retière C, Willem C, Guillaume T, Vié H, Gautreau-Rolland L, Scotet E, Saulquin X, Gagne K, Béné MC, Imbert BM, Clemenceau B, Peterlin P, Garnier A, Chevallier P (2018) Impact on early outcomes and immune reconstitution of high-dose post-transplant cyclophosphamide vs anti-thymocyte globulin after reduced intensity conditioning peripheral blood stem cell allogeneic transplantation. Oncotarget 9:11451–11464. https://doi.org/10.18632/oncotarget.24328

    Article  PubMed  PubMed Central  Google Scholar 

  36. Nunes NS, Kanakry CG (2019) Mechanisms of graft-versus-host disease prevention by post-transplantation cyclophosphamide: an evolving understanding. Front Immunol 10:2668. https://doi.org/10.3389/fimmu.2019.02668

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Mohty M (2007) Mechanisms of action of antithymocyte globulin: T-cell depletion and beyond. Leukemia 21:1387–1394. https://doi.org/10.1038/sj.leu.2404683

    Article  CAS  PubMed  Google Scholar 

  38. Stem Cell Trialists’ Collaborative Group (2005) Allogeneic peripheral blood stem-cell compared with bone marrow transplantation in the management of hematologic malignancies: an individual patient data meta-analysis of nine randomized trials. JCO 23:5074–5087. https://doi.org/10.1200/JCO.2005.09.020

    Article  Google Scholar 

  39. Kwon M, Bautista G, Balsalobre P et al (2017) Haplo-cord transplantation compared to haploidentical transplantation with post-transplant cyclophosphamide in patients with AML. Bone Marrow Transplant 52:1138–1143. https://doi.org/10.1038/bmt.2017.36

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We thank the staff and nurses of all the hematology and transplant units for their care and contributions to making this work possible. We thank Jose María Bellón from the Gregorio Marañón Health Research Institute for data analysis.

Funding

This work was partially supported by the Ministry of Economy and Competitiveness ISCIII-FIS grants PI08/1463, PI11/00708, PI14/01731, and RD12/0036/0061, co-financed by ERDF (FEDER) Funds from the European Commission, “A way of making Europe”, as well as grants from the Fundación LAIR, Asociación Madrileña de Hematología y Hemoterapia (AMHH), Asociación Española Contra el Cáncer (AECC), and Fundación Mutua Madrileña (FMM).

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  1. Rebeca Bailén and Mi Kwon contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    Rebeca Bailén, Mi Kwon, Gillen Oarbeascoa, Nieves Dorado, Ignacio Gómez-Centurión, Cristina Muñoz, Carolina Martínez-Laperche, Javier Anguita, Ismael Buño & José Luis Díez-Martín

  2. Gregorio Marañón Health Research Institute, Madrid, Spain

    Rebeca Bailén, Mi Kwon, Gillen Oarbeascoa, Nieves Dorado, Carolina Martínez-Laperche, Javier Anguita, Ismael Buño & José Luis Díez-Martín

  3. Department of Hematology and Hemotherapy, Hospital Regional Universitario de Málaga, Málaga, Spain

    María Jesús Pascual-Cascón, Anabel Gallardo-Morillo & Abel García-Sola

  4. Department of Hematology and Hemotherapy, Institut Català d’Oncologia Badalona, Barcelona, Spain

    Christelle Ferrà, Anna Torrent & María José Jiménez-Lorenzo

  5. Department of Hematology and Hemotherapy, Hospital Universitario y Politécnico La Fe, Valencia, Spain

    Jaime Sanz, José Luis Piñana & Juan Montoro

  6. Universidad Complutense de Madrid, Madrid, Spain

    Javier Anguita & José Luis Díez-Martín

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on behalf of Grupo Español de Trasplante Hematopoyético y Terapia Celular (GETH)

Contributions

Conception and design: MK and RB.

Provision of study materials or patients: All authors.

Collection and assembly of data: MK, RB, MJPC, AT, and JS.

Data analysis and interpretation: All authors.

Manuscript writing: MK, RB, MJPC, CF, and JS.

Revision and final approval of manuscript: All authors.

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Correspondence to Rebeca Bailén.

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Bailén, R., Kwon, M., Pascual-Cascón, M.J. et al. Post-transplant cyclophosphamide for GVHD prophylaxis compared to ATG-based prophylaxis in unrelated donor transplantation. Ann Hematol 100, 541–553 (2021). https://doi.org/10.1007/s00277-020-04317-7

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