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Bone marrow graft versus peripheral blood graft in haploidentical hematopoietic stem cells transplantation: a retrospective analysis in1344 patients of SFGM-TC registry. | LitMetric

AI Article Synopsis

  • The study analyzes the effectiveness of peripheral blood (PB) versus bone marrow (BM) stem cell grafts in haploidentical hematopoietic stem cell transplantation, particularly focusing on preventing graft-versus-host disease (GVHD) using post-transplant cyclophosphamide (PTCy) and anti-thymoglobulin (ATG).
  • Results showed that BM grafts were associated with lower rates of acute GVHD compared to PB grafts, and adding ATG did not provide any additional benefits.
  • In patients with acute leukemia and related conditions, while the relapse risk was higher for those receiving BM grafts with non-myeloablative conditioning, comparable outcomes were observed between graft types when an intensified conditioning regimen was used

Article Abstract

The use of peripheral blood (PB) or bone marrow (BM) stem cells graft in haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis remains controversial. Moreover, the value of adding anti-thymoglobulin (ATG) to PTCy is unknown. A total of 1344 adult patients received an unmanipulated haploidentical transplant at 37 centers from 2012 to 2019 for hematologic malignancy. We compared the outcomes of patients according to the type of graft, using a propensity score analysis. In total population, grade II-IV and III-IV acute GVHD (aGVHD) were lower with BM than with PB. Grade III-IV aGVHD was lower with BM than with PB + ATG. All outcomes were similar in PB and PB + ATG groups. Then, in total population, adding ATG does not benefit the procedure. In acute leukemia, myelodysplastic syndrome and myeloproliferative syndrome (AL-MDS-MPS) subgroup receiving non-myeloablative conditioning, risk of relapse was twice greater with BM than with PB (51 vs. 22%, respectively). Conversely, risk of aGVHD was greater with PB (38% for aGVHD II-IV; 16% for aGVHD III-IV) than with BM (28% for aGVHD II-IV; 8% for aGVHD III-IV). In this subgroup with intensified conditioning regimen, risk of relapse became similar with PB and BM but risk of aGVHD III-IV remained higher with PB than with BM graft (HR = 2.0; range [1.17-3.43], p = 0.012).

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773006PMC
http://dx.doi.org/10.1186/s13045-023-01515-4DOI Listing

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