Grade 2 acute GVHD is a factor of good prognosis in patients receiving peripheral blood stem cells haplo-transplant with post-transplant cyclophosphamide

Chevallier, Patrice; Berceanu, Ana; Péterlin, Pierre; Garnier, Alice; Bourgeois, Amandine Le; Imbert, Berthe‐Marie; Mahé, Béatrice; Dubruille, Viviane; Blin, Nicolas; Touzeau, Cyrille; Gastinne, Thomas; Lok, Anne; Tessoulin, Benoît; Vantyghem, Sophie; Desbrosses, Yohan; Bressollette, Céline; Duquesne, Alix; Eveillard, Marion; Bris, Yannick Le; Dormoy, Anne; Malugani, Caroline; Deconinck, Eric; Moreau, Philippe; Gouill, Steven Le; Béné, Marie C.; Guillaume, Thierry

doi:10.1080/0284186x.2020.1837947

Cited by 7 publications

(3 citation statements)

References 41 publications

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“…Chronic GVHD showed a trend towards reduction of relapse but no effect on survival. Similarly, a French study showed improved outcome after haploidentical SCT with acute GVHD grade II [30]. The Baltimore group also reported similar observations with the use of PTCy after HLA-matched transplants [31].…”

Section: Discussionmentioning

confidence: 73%

Post-transplant cyclophosphamide separates graft-versus host disease and graft versus leukemia effects after HLA- matched stem-cell transplantation for AML

Shimoni,

Peczynski,

Labopin

et al. 2024

Preprint

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The association of graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) effects after allogeneic stem-cell transplantation (SCT) is well-established but was not confirmed in modern era and following post-transplant cyclophosphamide (PTCy). We assessed GVHD/ GVL association in AML patients following HLA-matched SCT with standard calcineurin-based (n = 12,653) or PTCy-based (n = 508) GVHD prophylaxis. Following standard prophylaxis, the rates of acute GVHD grade II-IV and III-IV, chronic GVHD and extensive chronic GVHD were 23.8%, 7.5%, 37.0% and 16.3%, respectively. Acute GVHD grade II and III-IV were associated with lower relapse [hazard-ratio (HR) 0.85, P = 0.002; HR 0.76, P = 0.003, respectively)], higher non-relapse mortality (NRM) (HR 1.5, P < 0.001; HR 6.21, P < 0.001) and lower overall-survival (OS) (HR 1.49, P < 0.001; HR 6.1, P < 0.001). Extensive chronic GVHD was associated with lower relapse (HR 0.69, P < 0.001), higher NRM (HR 2.83, P < 0.001) and lower OS (HR 2.74, P < 0.001). Following PTCy, GVHD rates were 22.8%, 6.2%, 35.5% and 17.7%, respectively. Acute GVHD grade II-IV was not associated with relapse (HR 1.37, P = 0.15) but predicted higher NRM (HR 3.34, P < 0.001) and lower OS (HR 1.92, P = 0.001). Chronic GVHD was not prognostic for these outcomes. In conclusion, GVHD and GVL are strongly associated in contemporary SCT. However, following PTCy, GVHD is not associated with reduced relapse.

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Section: Discussionmentioning

confidence: 73%

Post-transplant cyclophosphamide separates graft-versus host disease and graft versus leukemia effects after HLA- matched stem-cell transplantation for AML

Shimoni,

Peczynski,

Labopin

et al. 2024

Preprint

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“…The prevalence of grades III and IV GVHD can be greatly decreased with a PTCY-based GVHD prophylaxis. According to a recent retrospective research ( 74 ), the elderly patients’ survival outcomes benefit from the continuity of grade II aGVHD. Better DFS (HR: 0.36; p = 0.002) and OS (HR: 0.35; p = 0.003) for elderly patients with grade II aGVHD continue to show a substantial correlation, which may be attributable to controlled aGVHD and contributing to the GVL effect.…”

Section: Management Of Post-transplant Complicationsmentioning

confidence: 99%

“…Relapse in patients undergoing HSCT is strongly predicted by MRD positivity, BM CD34+ donor cell chimerism <80%, and persistent positivity for gene mutation or chromosomal gain or loss [74][75]. When the aforementioned risk factors appeared, we opted for preemptive treatment.…”

Section: Treatment Of Recurrence 721 Preemptive Treatment Of Recurrencementioning

confidence: 99%

How to improve the outcomes of elderly acute myeloid leukemia patients through allogeneic hematopoietic stem cell transplantation

Jiang

Yan

et al. 2023

Front. Immunol.

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In recent years, with the gradual advancement of haploidentical transplantation technology, the availability of donors has increased significantly, along with the widespread use of reduced-intensity conditioning and the improvement of nursing techniques, giving more elderly acute myeloid leukemia (AML) patients the chance to receive allogeneic hematopoietic stem cell transplantation. We have summarized the classic and recently proposed pre-transplant assessment methods and assessed the various sources of donors, conditioning regimens, and post-transplant complication management based on the outcomes of large-scale clinical studies for elderly AML patients.

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Allogeneic hematopoietic cell transplantation from alternative donors in acute myeloid leukemia

Sugita,

Morita,

Konuma

et al. 2024

Ann Hematol

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Grade 2 acute GVHD is a factor of good prognosis in patients receiving peripheral blood stem cells haplo-transplant with post-transplant cyclophosphamide

Abstract: Guillaume (2020): Grade 2 acute GVHD is a factor of good prognosis in patients receiving peripheral blood stem cells haplo-transplant with post-transplant cyclophosphamide, Acta Oncologica,

Cited by 7 publications

References 41 publications

Post-transplant cyclophosphamide separates graft-versus host disease and graft versus leukemia effects after HLA- matched stem-cell transplantation for AML

Post-transplant cyclophosphamide separates graft-versus host disease and graft versus leukemia effects after HLA- matched stem-cell transplantation for AML

How to improve the outcomes of elderly acute myeloid leukemia patients through allogeneic hematopoietic stem cell transplantation

Allogeneic hematopoietic cell transplantation from alternative donors in acute myeloid leukemia

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