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cancers-17-04029.pdf (1.69 MB)

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2025-12-18

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cc-by (c) Tomaszewska, Agnieszka et al., 2025
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/228756

Complications of Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide—A Prospective Study on Behalf of the EBMT Transplant Complications Working Party

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https://doi.org/10.3390/cancers17244029

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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.

Matèries

Trasplantament d'òrgans, Hemofília, Hematopoesi

Matèries (anglès)

Transplantation of organs, Hemophilia, Hematopoiesis

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Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

TOMASZEWSKA, Agnieszka, BASAK, Grzegorz w., PECZYNSKI, Christophe, POLGE, Emmanuelle, AMBRON, Pascale, BORELAND, William, SICA, Simona, ARAT, Mutlu, PASSWEG, Jakob, LÓPEZ LORENZO, José luis, SALMENNIEMI, Urpu, JINDRA, Pavel, KULAGIN, Alexander, MARTINO BUFARULL, Rodrigo, EDER, Matthias, BEKADJA, Mohamed amine, MUSSETTI, Alberto, GRAHAM, Charlotte e., SCHOEMANS, Hélène, PENACK, Olaf, MOISEEV, Ivan, PERIĆ, Zinaida. Complications of Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide—A Prospective Study on Behalf of the EBMT Transplant Complications Working Party. _Cancers_. 2025. Vol. 17, núm. 24, pàgs. 4029. [consulta: 5 de maig de 2026]. [Disponible a: https://hdl.handle.net/2445/228756]

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