Reduced dose of posttransplant cyclophosphamide in HLA-haploidentical peripheral blood stem cell transplantation

Junichi Sugita, Tomohiko Kamimura, Takayuki Ishikawa, Shuichi Ota, Tetsuya Eto, Takashi Kuroha, Yasuhiko Miyazaki, Hiroaki Kumagai, Keitaro Matsuo, Koichi Akashi, Shuichi Taniguchi, Mine Harada, Takanori Teshima

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)

Abstract

Posttransplant cyclophosphamide (PTCy:100 mg/kg) has been increasingly used in allogeneic hematopoietic stem cell transplantation, however, few studies compared different doses of PTCy. We conducted two consecutive prospective multicenter phase II studies to evaluate the safety and efficacy of 80 mg/kg of PTCy in 137 patients who underwent HLA-haploidentical peripheral blood stem cell transplantation (haploPBSCT) following reduced-intensity conditioning (RIC). GVHD prophylaxis consisted of PTCy at a dose of 40 mg/kg/day on days 3 and 4, tacrolimus, and mycophenolate mofetil. Neutrophil engraftment was achieved in 97% and 96% in the first and second studies, respectively. The incidences of grades II–IV acute GVHD, III–IV acute GVHD, all grade chronic GVHD, and moderate to severe chronic GVHD at 2 years were 26%, 5%, 35%, and 18% in the first study, and 23%, 1%, 28%, and 15% in the second study, respectively. Overall survival (OS), disease-free survival (DFS), and non-relapse mortality (NRM) at 2 years were 51%, 42%, and 18% in the first study, and 58%, 48%, and 16% in the second study, respectively. The rates of off-immunosuppressants in patients who survived without relapse at 2 years were 83 and 76%. Our results suggest that 80 mg/kg of PTCy is a valid option in haploPBSCT following RIC.

Original languageEnglish
Pages (from-to)596-604
Number of pages9
JournalBone Marrow Transplantation
Volume56
Issue number3
DOIs
Publication statusPublished - Mar 2021

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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