Clinical study of the efficacies of ruxolitinib plus low-dose PTCY for acute GVHD prevention after haploidentical transplantation in malignant hematological diseases
10.3760/cma.j.cn121090-20230929-00153
- VernacularTitle:芦可替尼联合低剂量后置环磷酰胺预防恶性血液病单倍体造血干细胞移植急性移植物抗宿主病的临床研究
- Author:
Xiaoping LI
1
;
Yu LI
;
Lin LIU
;
Zhongtao YUAN
;
Youcheng WANG
;
Yancheng DONG
;
Dingsong ZHANG
;
Jing FENG
;
Yingnian CHEN
;
Sanbin WANG
Author Information
1. 联勤保障部队第九二〇医院血液科，昆明 650000
- Keywords:
Ruxolitinib;
Graft versus host disease;
Haploidentical hematopoietic stem cell transplantation;
Cyclophosphamide
- From:
Chinese Journal of Hematology
2024;45(2):128-133
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate and verify a novel acute graft versus host disease (aGVHD) prevention protocol in the context of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) .Methods:Patients who underwent haplo-HSCT in our center between January 2022 and December 2022 were included. All patients received reduced doses of cyclophosphamide, Rabbit anti-human tymoglobulin, ruxolitinib, methotrexate, cyclosporine, and MMF to prevent aGVHD. The transplantation outcomes, complications, and survival rate of all patients were investigated.Results:A total of 52 patients with haplo-HSCT were enrolled, 29 (55.8%) male and 23 (44.2%) female, with a median age of 28 (5-59) years. There were 25 cases of acute myeloid leukemia, 17 cases of acute lymphocyte leukemia, 6 cases of myelodysplastic syndrome, 2 cases of chronic myeloid leukemia and 2 cases of myeloproliferative neoplasms. 98.1% of patients had successful engraftment. The incidence of Ⅱ-Ⅳ aGVHD and Ⅲ-Ⅳ aGVHD was 19.2% (95% CI 8.2% -30.3% ) and 7.7% (95% CI 0.2% -15.2% ), respectively. No patients experienced severe gastrointestinal mucositis. The Epstein-Barr virus and CMV reactivation rates were 40.4% and 21.3%, respectively. 9.6% of patients relapsed during followup, with 1-year overall survival, progression-free survival, and non-relapse mortality rates of 86.5% (95% CI 76.9% -96.1% ), 78.8% (95% CI 67.4% -90.3% ) and 11.5% (95% CI 2.6% –20.5% ), respectively. Conclusion:Ruxolitinib combined with a low dose of PTCY is a safe and effective first-line aGVHD prevention strategy.
