Cyclosporine/methotrexate versus tacrolimus/methotrexate with or without anti-thymocyte globulin as GVHD prophylaxis in adult patients with aplastic anemia View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-10-09

AUTHORS

Yasushi Onishi, Takehiko Mori, Hirohito Yamazaki, Katsuto Takenaka, Hiroki Yamaguchi, Naoki Shingai, Yukiyasu Ozawa, Hiroatsu Iida, Shuichi Ota, Naoyuki Uchida, Toshihiro Miyamoto, Yuta Katayama, Jun Kato, Satoshi Yoshioka, Makoto Onizuka, Tatsuo Ichinohe, Yoshiko Atsuta

ABSTRACT

The impact of calcineurin inhibitor types and anti-thymocyte globulin (ATG) in conditioning on overall survival (OS) and GVHD-free, relapse-free survival (GRFS) has not yet been analyzed in detail for aplastic anemia. We herein examined 517 adult patients with aplastic anemia who underwent BMT from HLA-matched sibling donors (MSD, n = 255) and unrelated donors (UD, n = 262) and were treated with cyclosporine A (CSA) + methotrexate (MTX) (n = 258) and tacrolimus (TAC) + MTX (n = 259). In total, 330 patients received ATG in conditioning. CSA + MTX versus TAC + MTX did not have a significant impact on acute and chronic GVHD, OS, or GRFS in each donor type. The use of ATG in conditioning reduced the risk of grade II–IV acute GVHD in the MSD and UD cohorts (HR 0.42, P = 0.014, and HR 0.3, P < 0.001, respectively); however, a differential impact on GRFS was identified, namely, better GRFS in MSD recipients (HR 0.56, P = 0.016), but not in UD recipients (HR 1.1, P = 0.657). In conclusion, CSA + MTX and TAC + MTX were similar as GVHD prophylaxis regardless of the donor type, and ATG in conditioning increased GRFS in MSD transplants, but not in UD transplants. More... »

PAGES

217-228

Journal

TITLE

Annals of Hematology

ISSUE

1

VOLUME

100

Author Affiliations

  • Department of Hematology and Rheumatology, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, 980-8574, Sendai, Miyagi, Japan
  • Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
  • Division of Transfusion Medicine, Kanazawa University Hospital, Kanazawa, Japan
  • Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Matsuyama, Japan
  • Department of Hematology, Nippon Medical School, Tokyo, Japan
  • Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
  • Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
  • Division of Cell Therapy, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
  • Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
  • Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
  • Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
  • Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
  • Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan
  • Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00277-020-04290-1

    DOI

    http://dx.doi.org/10.1007/s00277-020-04290-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1131532649

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33033911


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