Complications of Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide-A Prospective Study on Behalf of the EBMT Transplant Complications Working Party
Por:
Tomaszewska, A, Basak, GW, Peczynski, C, Polge, E, Ambron, P, Boreland, W, Sica, S, Arat, M, Passweg, J, Lorenzo, JLL, Salmenniemi, U, Jindra, P, Kulagin, A, Bufarull, RM, Eder, M, Bekadja, MA, Mussetti, A, Graham, CE, Schoemans, H, Penack, O, Moiseev, I, Peric, Z
Publicada:
18 dic 2025
Resumen:
Background: Haploidentical hematopoietic cell transplantations (haplo-HCTs) with post-transplant cyclophosphamide (PT-Cy) are standard practice, but complications causing morbidity and mortality are not well described. Methods: The aim of this prospective non-interventional multicenter study was to document frequency of potential non-infectious and infection-related complications and main transplant outcomes after the first unmanipulated haplo-HCT with PT-Cy between 2017 and 2019 in 129 adult patients with hematological malignancies. The median follow-up was 37.3 months [95% CI: 34.3-39.7]. Results: The cumulative incidence (CI) of acute graft versus host disease (aGvHD) at day +100 was 22.4% grade II-IV [95% CI: 15.5-30.1] and 8.8% grade III-IV [95% CI: 4.6-14.6], respectively. The cumulative incidence of chronic GvHD (cGvHD) at 24 months was 25.8% [95% CI: 18.5-33.6]; extensive cGvHD was 10.9% [95% CI: 6.3-17.1], respectively. The most frequent non-infectious complications for the whole study population were mucositis-37.5% (n = 48); renal insufficiency-18% (n = 23); and cardiovascular complications-10.9% (n = 14). The following infection-related complications were diagnosed: bacterial in 84 (65.1%), viral in 66 (51.6%), and fungal in 24 (18.6%) recipients. Two-year OS was 58.1% [95% CI: 50.2-67.3]; NRM-27.1% [95% CI: 19.7-35]; PFS-50.4% [95% CI: 42.5-59.8]; and GRFS-38.8% [95% CI: 31.2-48.1]. About 50% of all deaths were directly caused by infection or infection-related conditions. Conclusions: Disease remission status at transplant significantly affected PFS, chronic GvHD, and GRFS. Although clinical applications of haplo-HCT with PTCy are widespread, the study confirms the need to reduce infection-related mortality after this type of GvHD prophylaxis.
Filiaciones:
Tomaszewska, A:
Med Univ Warsaw, Dept Hematol Transplantat & Internal Med, PL-02091 Warsaw, Poland
Basak, GW:
Med Univ Warsaw, Dept Hematol Transplantat & Internal Med, PL-02091 Warsaw, Poland
Peczynski, C:
Sorbonne Univ, St Antoine Hosp, Dept Haematol, EBMT Paris Study Unit,INSERM,UMR S 938, F-75012 Paris, France
Polge, E:
Sorbonne Univ, St Antoine Hosp, Dept Haematol, EBMT Paris Study Unit,INSERM,UMR S 938, F-75012 Paris, France
Ambron, P:
Sorbonne Univ, St Antoine Hosp, Dept Haematol, EBMT Paris Study Unit,INSERM,UMR S 938, F-75012 Paris, France
Boreland, W:
Sorbonne Univ, St Antoine Hosp, Dept Haematol, EBMT Paris Study Unit,INSERM,UMR S 938, F-75012 Paris, France
Sica, S:
Univ Cattolica S Cuore, Dipartimento Sci Radiol & Ematol, I-00168 Rome, Italy
Arat, M:
Sisli Mem Hosp, Dept Hematol & Transplantat, TR-34384 Istanbul, Turkiye
Bahcesehir Univ, Fac Med, TR-34734 Istanbul, Turkiye
Passweg, J:
Univ Hosp Basel, CH-4031 Basel, Switzerland
Lorenzo, JLL:
Hosp Univ Fdn Jimenez Diaz, Madrid 28040, Spain
Salmenniemi, U:
HUS Comprehens Canc Ctr, FIN-00029 Helsinki, Finland
Jindra, P:
Charles Univ Hosp, Plzen 30100, Czech Republic
Kulagin, A:
Pavlov Univ, RM Gorbacheva Res Inst, St Petersburg 197022, Russia
Bufarull, RM:
Hosp Santa Creu I St Pau, Barcelona 08025, Spain
Eder, M:
Hannover Med Sch, Dept Hematol Hemostasis Oncol & Stem Cell Transpla, D-30625 Hannover, Germany
Bekadja, MA:
Ahmed Benbella 1 Univ, Fac Med, Oran 31000, Algeria
Mussetti, A:
Hosp Duran i Reynals, Inst Catala Oncol, Barcelona 199203, Spain
Graham, CE:
Kings Coll London, Comprehens Canc Ctr, London WC2R 2LS, England
Schoemans, H:
Univ Hosp Gasthuisberg, B-3000 Leuven, Belgium
Penack, O:
Univ Med Berlin, Charite CVK, D-13353 Berlin, Germany
Moiseev, I:
Pavlov Univ, RM Gorbacheva Res Inst, St Petersburg 197022, Russia
Peric, Z:
Univ Hosp Ctr Rijeka, Rijeka 51000, Croatia
Univ Rijeka, Sch Med, Rijeka 51000, Croatia
Green Submitted, gold
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