Clinical observation on the effect of RIC-PTCY on allogeneic hematopoietic stem cell transplantation in patients with hematologic malignancies
10.3760/cma.j.cn421203-20231125-00175
- VernacularTitle:RIC-PTCY方案对allo-HSCT治疗恶性血液病的疗效观察
- Author:
Yanting LI
1
;
Yujie LIU
1
;
Yang XU
1
;
Depei WU
1
Author Information
1. 苏州大学附属第一医院血液内科 国家血液系统疾病临床医学研究中心 江苏省血液研究所 中华人民共和国国家卫生健康委员会血栓与止血重点实验室 苏州大学造血干细胞移植研究所，苏州 215006
- Publication Type:Journal Article
- Keywords:
Hematopoietic stem cell transplantation;
Allogeneic hematopoietic stem cell transplantation;
Graft versus host disease;
Cyclophosphamide;
Malignant hemato
- From:
Chinese Journal of Organ Transplantation
2025;46(11):741-748
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of reduced intensity conditioning (RIC) combined with posttransplant high-dose cyclophosphamide (PTCY) in the treatment of high-risk and relapsed/refractory malignant hematological diseases through allogeneic hematopoietic stem cell transplantation (allo-HSCT).Method:A retrospective analysis was conducted on clinical data of 42 recipients with high-risk or relapsed/refractory malignant hematological diseases who underwent allo-HSCT using the RIC-PTCY regimen at the First Affiliated Hospital of Soochow University from December 2014 to August 2023. Data were collected on engraftment rate, incidence of graft-versus-host disease (GVHD), infections, relapse, and survival outcomes.Result:The median age of the 42 recipients was 52.5 years (range, 20-75 years). Among them, 23 were classified as high-risk and 19 as relapsed/refractory. Three recipients experienced graft failure, and one recipient died of infection early after transplantation. The remaining 38 recipients achieved complete donor chimerism at a median of 21 days (range, 9-52 days). The median time to neutrophil and platelet engraftment was 14 days (range, 9-27 days) and 15 days (range, 7-51 days), respectively. The cumulative incidence (CI) of grade I-II and grade III-IV acute GVHD (aGVHD) at 100 days post-transplantation was 23.7% and 18.4%, respectively. The 2-year CI of chronic GVHD (cGVHD) was 30.1%, with no moderate-to-severe cGVHD observed. The CI of pulmonary and bloodstream infections was 45.2%. The CI of infections with cytomegalovirus (CMV), Epstein-Barr virus (EBV), and BK virus (BKV) was 21.1%, 2.9%, and 7.9%, respectively. The CI of grade I-II hemorrhagic cystitis was 15.8%. The median follow-up duration was 11.2 months (range, 0.4-106.9 months). At the last follow-up, the overall survival (OS) and disease-free survival (DFS) rates were 40.7% and 38.5%, respectively. The cumulative incidence of relapse and non-relapse mortality (NRM) was 44.9% and 19.5%, respectively.Conclusion:The RIC-PTCY regimen may improve early post-transplant outcomes and broaden donor availability. recipients with high-risk or relapsed/refractory malignant hematologic diseases may benefit from this transplantation strategy.
