Holtick, Udo, Chemnitz, Jens-Markus, Shimabukuro-Vornhagen, Alexander ORCID: 0000-0002-2351-7294, Theurich, Sebastian ORCID: 0000-0001-5706-8258, Chakupurakal, Geothy, Krause, Anke, Fiedler, Anne, Luznik, Leo, Hellmich, Martin, Wolf, Dominik, Hallek, Michael, von Bergwelt-Baildon, Michael and Scheid, Christof (2016). OCTET-CY: a phase II study to investigate the efficacy of post-transplant cyclophosphamide as sole graft-versus-host prophylaxis after allogeneic peripheral blood stem cell transplantation. Eur. J. Haematol., 96 (1). S. 27 - 36. HOBOKEN: WILEY. ISSN 1600-0609

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Abstract

Objective: Post-transplant cyclophosphamide is increasingly used as graft-versus-host disease (GvHD) prophylaxis in the setting of bone marrow transplantation. No data have been published on the use of single-agent GvHD prophylaxis with post-transplant cyclophosphamide in the setting of peripheral blood stem cell transplantation (PBSCT). Methods: In a phase II trial, 11 patients with myeloma or lymphoma underwent conditioning with fludarabine and busulfan followed by T-replete PBSCT and application of 50 mg/kg/d of cyclophosphamide on day+3 and +4 without other concurrent immunosuppression ( IS). Results: Median time to leukocyte, neutrophil, and platelet engraftment was 18, 21, and 18 d. The incidence of grade II-IV and grade III-IV GvHD was 45% and 27%, with a non-relapse mortality (NRM) of 36% at one and 2 yr. After median follow-up of 927 d, overall and relapse-free survival was 64% and 34%. Three patients did not require any further systemic IS until day+100 and thereafter. Analysis of immune reconstitution demonstrated rapid T- and NK-cell recovery. B- and CD3+/CD161+NK/T-cell recovery was superior in patients not receiving additional IS. Conclusion: Post-transplant cyclophosphamide as sole IS in PBSCT is feasible and allows rapid immune recovery. Increased rates of severe acute GvHD explain the observed NRM and may advise a temporary combination partner such as mTor-inhibitors in the PBSCT setting.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Holtick, UdoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chemnitz, Jens-MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shimabukuro-Vornhagen, AlexanderUNSPECIFIEDorcid.org/0000-0002-2351-7294UNSPECIFIED
Theurich, SebastianUNSPECIFIEDorcid.org/0000-0001-5706-8258UNSPECIFIED
Chakupurakal, GeothyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krause, AnkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fiedler, AnneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luznik, LeoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hellmich, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wolf, DominikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hallek, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Bergwelt-Baildon, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scheid, ChristofUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-291753
DOI: 10.1111/ejh.12541
Journal or Publication Title: Eur. J. Haematol.
Volume: 96
Number: 1
Page Range: S. 27 - 36
Date: 2016
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1600-0609
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
BONE-MARROW-TRANSPLANTATION; HIGH-DOSE CYCLOPHOSPHAMIDE; SKIN ALLOGRAFT TOLERANCE; AGENT GVHD PROPHYLAXIS; SINGLE-AGENT; DISEASE PROPHYLAXIS; COMPARING METHOTREXATE; HODGKIN-LYMPHOMA; CYCLOSPORINE; MICEMultiple languages
HematologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/29175

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