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Tacrolimus versus cyclosporine a combined with post-transplantation cyclophosphamide for AML In first complete remission: a study from the acute leukemia working party (EBMT)
G. Bug, M. Labopin, A. Kulagin, D. Blaise, AM. Raiola, J. Vydra, S. Sica, M. Kwon, L. López-Corral, S. Bramanti, P. von dem Borne, M. Itälä-Remes, M. Martino, Y. Koc, E. Brissot, S. Giebel, A. Nagler, F. Ciceri, M. Mohty
Language English Country England, Great Britain
Document type Journal Article, Comparative Study, Multicenter Study
NLK
Free Medical Journals
from 1997 to 1 year ago
Freely Accessible Science Journals
from 1997 to 1 year ago
ProQuest Central
from 2000-01-01 to 1 year ago
Open Access Digital Library
from 1997-01-01
Health & Medicine (ProQuest)
from 2000-01-01 to 1 year ago
- MeSH
- Leukemia, Myeloid, Acute * therapy mortality MeSH
- Cyclophosphamide * therapeutic use MeSH
- Cyclosporine * therapeutic use MeSH
- Child MeSH
- Adult MeSH
- Immunosuppressive Agents therapeutic use MeSH
- Remission Induction MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Graft vs Host Disease * prevention & control mortality etiology MeSH
- Child, Preschool MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Tacrolimus * therapeutic use MeSH
- Hematopoietic Stem Cell Transplantation * methods MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Child, Preschool MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Comparative Study MeSH
Choice of calcineurin inhibitor may impact the outcome of patients undergoing T-cell replete hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PT-Cy) and mycophenolate mofetil (MMF) for prophylaxis of graft-versus-host disease (GVHD). We retrospectively analyzed 2427 patients with acute myeloid leukemia (AML) in first remission transplanted from a haploidentical (n = 1844) or unrelated donor (UD, n = 583) using cyclosporine A (CSA, 63%) or tacrolimus (TAC, 37%) and PT-Cy/MMF. In univariate analysis, CSA and TAC groups did not differ in 2-year leukemia-free or overall survival, cumulative incidence (CI) of relapse or non-relapse mortality. CI of severe grade III-IV acute GVHD was lower with TAC (6.6% vs. 9.1%, p = 0.02), without difference in grade II-IV acute GVHD or grade III-IV acute GVHD/severe chronic GVHD, relapse-free survival (GRFS). In multivariate analysis, TAC was associated with a lower risk of severe grade III-IV acute GVHD solely with haploidentical donors (HR 0.64 [95% CI, 0.42-0.98], p = 0.04), but not UD (HR 0.49 [95% CI, 0.2-1.21], p = 0.12). There was no significant difference for chronic GVHD. In conclusion, PT-Cy/MMF-based GVHD prophylaxis resulted in favorable OS and GRFS, irrespective of the CNI added. In haploidentical HCT, TAC seemed to prevent severe acute GVHD more effectively than CSA without impact on other outcome parameters.
Chaim Sheba Medical Center Tel Hashomer Israel
Goethe University Frankfurt University Hospital Dept of Medicine 2 Frankfurt am Main Germany
Hospital Universitario de Salamanca Salamanca Spain
Institute of Hematology and Blood Transfusion Prague Czech Republic
IRCCS San Martino Hospital Genova Italy
IRCCS San Raffaele Scientific Institute Milan Italy
Leiden University Medical Center Leiden Netherlands
Maria Sklodowska Curie National Research Institute of Oncology Gliwice Branch Gliwice Poland
Medicana International Hospital Istanbul Turkey
RM Gorbacheva Research Institute Pavlov University St Petersburg Russian Federation
Sorbonne University Department of Hematology Saint Antoine Hospital INSERM UMR 938 Paris France
References provided by Crossref.org
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