Universität zu Köln

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:	Creators Email ORCID ORCID Put Code Holtick, Udo UNSPECIFIED UNSPECIFIED UNSPECIFIED Chemnitz, Jens-Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Shimabukuro-Vornhagen, Alexander UNSPECIFIED orcid.org/0000-0002-2351-7294 UNSPECIFIED Theurich, Sebastian UNSPECIFIED orcid.org/0000-0001-5706-8258 UNSPECIFIED Chakupurakal, Geothy UNSPECIFIED UNSPECIFIED UNSPECIFIED Krause, Anke UNSPECIFIED UNSPECIFIED UNSPECIFIED Fiedler, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Luznik, Leo UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, Dominik UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED von Bergwelt-Baildon, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheid, Christof UNSPECIFIED UNSPECIFIED UNSPECIFIED
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:	Keywords Language BONE-MARROW-TRANSPLANTATION; HIGH-DOSE CYCLOPHOSPHAMIDE; SKIN ALLOGRAFT TOLERANCE; AGENT GVHD PROPHYLAXIS; SINGLE-AGENT; DISEASE PROPHYLAXIS; COMPARING METHOTREXATE; HODGKIN-LYMPHOMA; CYCLOSPORINE; MICE Multiple languages Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/29175