Posttransplant cyclophosphamide versus antithymocyte globulin in patients with cardiovascular comorbidity undergoing allogeneic hematopoietic cell transplantation for acute myeloid leukaemia in first complete remission from unrelated donors: a retros
We retrospectively analyzed data from the EBMT registry on patients with pretransplant comorbidities associated with cardiovascular risk. Patients who underwent first allogeneic hematopoietic cell transplantation for acute myeloid leukemia in first complete remission between 2010 and 2022 from unrelated donors using post-transplant cyclophosphamide (ptCy) or anti-thymocyte globulin (ATG)-based graft-versus-host disease prophylaxis with a history of cardiac disease, arrhythmia, diabetes, obesity or cerebrovascular disease according to the HCT-specific comorbidity index were included. We performed a matched-pair analysis using a propensity score. After matching, 432 patients were included: 313 in the ATG group and 119 in the ptCy group. At 2 years, overall survival was 67.5% (95% CI 61-73.2) and 68.6% (95% CI 56.7-77.8); leukemia-free survival was 60.4% (95% CI 53.8-66.4) and 62.6% (95% CI 50.4-72.6); relapse incidence was 22.1% (95% CI 17-27.7) and 23.2% (95% CI 14.3-33.4); non-relapse mortality was 17.5% (95% CI 13.1-22.4) and 14.1% (95% CI 7.5-22.8), respectively. In conclusion, our study suggests that the use of ptCY for GVHD prophylaxis in patients with preexisting comorbidities associated with cardiovascular risk yields long-term outcomes comparable to those observed with ATG-based approaches.
Authors
- Nicolaus Martin Kröger (ORCID: https://orcid.org/0000-0001-5103-9966)
- Jakob Robert Passweg (ORCID: https://orcid.org/0000-0001-7092-3351)
- Matthias Stelljes (ORCID: https://orcid.org/0000-0002-9331-5145)
- Urpu Salmenniemi (ORCID: https://orcid.org/0009-0002-2053-3384)
- Alexandros Spyridonidis (ORCID: https://orcid.org/0000-0003-3097-2532)
- Mohamad Mohty (ORCID: https://orcid.org/0000-0002-7264-808X)
- Fabio Ciceri (ORCID: https://orcid.org/0000-0003-0873-0123)
- Allain‐Thibeault Ferhat
- Jan Vydra (ORCID: https://orcid.org/0000-0002-4274-3895)
- Cristina Castilla‐Llorente (ORCID: https://orcid.org/0000-0002-7728-5804)
- Ibrahim Yakoub‐Agha (ORCID: https://orcid.org/0000-0003-4524-8782)
- Alessandro Rambaldi (ORCID: https://orcid.org/0000-0002-3739-7502)
- Kristina Carlson (ORCID: https://orcid.org/0000-0002-0303-1350)
- Tobias Gedde‐Dahl (ORCID: https://orcid.org/0000-0002-3037-5378)
- Thomas A. Schroeder (ORCID: https://orcid.org/0000-0002-1653-7959)
- Robert Zeiser (ORCID: https://orcid.org/0000-0001-6565-3393)
- Bipin N. Savani (ORCID: https://orcid.org/0000-0002-3304-9965)
- Matthias Eder (ORCID: https://orcid.org/0009-0000-3362-5814)
- Régis Peffault de Latour
Institutions
- Oslo University Hospital (NO)
- Uppsala University Hospital (SE)
- Inserm (FR)
- Universität Hamburg (DE)
- University of Freiburg (DE)
- University of Patras (GR)
- University of Milan (IT)
- University of Münster (DE)
- Université de Lille (FR)
- Institut Gustave Roussy (FR)
- Saint Louis University Hospital (US)
- University Hospital of Basel (CH)
- Centre Hospitalier Universitaire de Lille (FR)
- Medizinische Hochschule Hannover (DE)
- Sorbonne Université (FR)
- Institute of Haematology and Blood Transfusion (CZ)
- Hôpital Saint-Antoine (FR)
- University Medical Center Hamburg-Eppendorf (DE)
- Essen University Hospital (DE)
- IRCCS Ospedale San Raffaele (IT)
- Centre de Recherche Saint-Antoine (FR)
- Hôpital Saint-Louis (FR)
- European Society for Blood and Marrow Transplantation (FR)
- Vanderbilt University Medical Center (US)
Publication Details
- Journal
- Bone Marrow Transplantation
- Published
- 2025-12-03
- DOI
- https://doi.org/10.1038/s41409-025-02766-0
- Primary Topic
- Hematopoietic Stem Cell Transplantation
- Type
- article
- Field-Weighted Citation Impact
- 0.00