Post-transplantation cyclophosphamide versus antithymocyte globulin in patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation from HLA-identical sibling donors: A retrospective analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

Giorgia Battipaglia*, Myriam Labopin, Rose-Marie Hamladji, Didier Blaise, Patrice Chevallier, Eolia Brissot, Armin Gerbitz, Gerard Socié, Boris Afanasyev, Fabio Ciceri, Ellen Meijer, Yener Koc, Jan J. Cornelissen, Anne Huynh, Hakan Ozdogu, Johan Maertens, Franciane Paul, H. lène Labussière-Wallet, Annalisa Ruggeri, Mahmoud AljurfAli Bazarbachi, Bipin Savani, Arnon Nagler, Mohamad Mohty

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Graft-versus-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Addition of antithymocyte globulin (ATG) or post-transplantation cyclophosphamide (PTCY) to standard immunosuppressive agents reduces GVHD in different donor settings. METHODS: We compared the outcomes of adults with acute myeloid leukemia undergoing allo-HSCT from HLA-identical sibling donors after the use of PTCY (n = 197) or ATG (n = 1913). RESULTS: Patients in the PTCY group were younger than those in the ATG group (median age, 47 vs 54 years; P <.01). Peripheral blood was the most frequently used stem cell source, being significantly more frequent in the ATG group than in the PTCY group (95% vs 70% P <.01). The conditioning regimen was more frequently myeloablative in the PTCY group than in the ATG group (59% vs 48%; P <.01). Time to neutrophil engraftment was shorter in the ATG group than in the PTCY group (17 vs 20 days; P <.01). No differences were observed according to the other transplantation outcomes, except for chronic GVHD of all grades and extensive chronic GVHD at 2 years, which were significantly lower in the ATG group compared with the PTCY group (P <.02). CONCLUSION: PTCY is feasible in an HLA-identical sibling setting, and despite similar outcomes, ATG may be associated with lower incidence of chronic GVHD.

Original languageEnglish
Pages (from-to)209-218
Number of pages10
JournalCancer
Volume127
Issue number2
Early online date2020
DOIs
Publication statusPublished - 15 Jan 2021

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