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This Improves Survival After HLA-Haplo Transplant
Biol Blood Marrow Transplant; ePub 2017 Oct 18; McCurdy, et al
Higher nucleated cell graft dose goals may improve survival after T-cell replete HLA-haploidentical (haplo) bone marrow transplantation (BMT) with posttransplantation cyclophosphamide (PTCy), according to a study involving 340 individuals. Participants had hematologic malignancies and engrafted after nonmyeloablative haplo BMT with PTCy, mycophenolate mofetil, and tacrolimus. Investigators looked at risk factors for and effects of GVHD on survival. Among the results:
- Overall rates of grade II and grade III-IV acute GVHD were 30% and 2%, respectively.
- 1-year overall rate of chronic GVHD was 10%.
- The 4-year probability of overall survival was 48% in patients without grade II-IV acute GVHD, vs 63% for those with.
- Progression-free survival rates were 39% and 59%, respectively.
- Patients with grade II acute GVHD had better overall and progression-free survival rates than those who never experienced GVHD.
- Higher nucleated cell graft dose was also linked with improved overall and progression-free survival, as well as decreased risk of grade III-IV acute GVHD.
McCurdy S, Kanakry C, Tsai H, et al. Grade II acute GVHD and higher nucleated cell graft dose improve progression-free survival after HLA-haploidentical transplant with posttransplant cyclophosphamide. [Published online ahead of print October 18, 2017]. Biol Blood Marrow Transplant. doi:10.1016/j.bbmt.2017.10.023.