PMID- 32846764
OWN - NLM
STAT- MEDLINE
DCOM- 20200908
LR  - 20210112
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 99
IP  - 34
DP  - 2020 Aug 21
TI  - A comparison of post-transplantation cyclophosphamide versus 
      antithymocyte-globulin in patients with hematological malignancies undergoing 
      HLA-matched unrelated donor transplantation.
PG  - e21571
LID - 10.1097/MD.0000000000021571 [doi]
LID - e21571
AB  - Post-transplantation cyclophosphamide (PTCy) and antithymocyte-globulin (ATG) are 
      the most commonly used regimens for prophylaxis of graft-versus-host disease 
      (GVHD). We compared these 2 regimens in human leukocyte antigen (HLA)-matched 
      unrelated donor hematopoietic stem cell transplantation (HSCT) patients with 
      hematological malignancies. We retrospectively analyzed consecutive adult 
      patients with hematological malignancies who underwent HLA-matched unrelated 
      donor-HSCT at Chungnam National University Hospital (Daejeon, South Korea) 
      between January 2013 and January 2019. Patients who received a second 
      transplantation or who had refractory disease were excluded. We included 34 
      patients (12 and 22 in the PTCy and ATG groups respectively). All graft sources 
      were peripheral blood stem cells. The estimated 20-month overall survival rates 
      were 75.0% for PTCy and 81.6% for ATG patients (P = .792), and the 20-month 
      relapse rates were 41.7% and 34.3% (P = .491), respectively. The cumulative 
      incidences of grade 2 to 4 acute GVHD were 16.7% and 30.6% (P = .551), 
      respectively; the estimated 20-month limited and extensive chronic GVHD rates 
      were 59.1% and 78.8% (P = .718), respectively; and the estimated 20-month 
      extensive chronic GVHD rates were 12.5% and 16.7% (P = .718), respectively. The 
      neutrophil engraftment time was similar in both groups [median (range), 15.0 
      (12.0-17.0) and 14.0 (12.0-19.0) days, respectively; P = .961]. However, ATG was 
      more expensive than PTCy [median (range), US$4,062 (US$2,215-6,647) for ATG vs 
      US$51.80 (US$43.20-69.20) for PTCy; P < .001]. In conclusion, PTCy and ATG 
      afforded similar clinical outcomes after HLA-matched unrelated donor 
      transplantation but PTCy was less expensive.
FAU - Lee, Myung-Won
AU  - Lee MW
AD  - Department of Internal Medicine.
AD  - Center of Hematopoietic stem cell transplantation, Chungnam National University 
      Hospital, South Korea.
FAU - Yeon, Sang Hoon
AU  - Yeon SH
AD  - Department of Internal Medicine.
FAU - Seo, Won-Hyoung
AU  - Seo WH
AD  - Department of Internal Medicine.
FAU - Ryu, Hyewon
AU  - Ryu H
AD  - Department of Internal Medicine.
FAU - Lee, Hyo-Jin
AU  - Lee HJ
AD  - Department of Internal Medicine.
FAU - Yun, Hwan-Jung
AU  - Yun HJ
AD  - Department of Internal Medicine.
FAU - Jo, Deog-Yeon
AU  - Jo DY
AD  - Department of Internal Medicine.
AD  - Center of Hematopoietic stem cell transplantation, Chungnam National University 
      Hospital, South Korea.
FAU - Song, Ik-Chan
AU  - Song IC
AUID- ORCID: 0000-0002-6938-970
AD  - Department of Internal Medicine.
AD  - Center of Hematopoietic stem cell transplantation, Chungnam National University 
      Hospital, South Korea.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antilymphocyte Serum)
RN  - 0 (Immunosuppressive Agents)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antilymphocyte Serum/*therapeutic use
MH  - Cyclophosphamide/*therapeutic use
MH  - Female
MH  - Graft vs Host Disease/etiology/*prevention & control
MH  - Hematologic Neoplasms/mortality/therapy
MH  - Hematopoietic Stem Cell Transplantation/adverse effects
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Republic of Korea/epidemiology
MH  - Retrospective Studies
MH  - Young Adult
PMC - PMC7447482
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2020/08/28 06:00
MHDA- 2020/09/09 06:00
PMCR- 2020/08/21
CRDT- 2020/08/28 06:00
PHST- 2020/08/28 06:00 [entrez]
PHST- 2020/08/28 06:00 [pubmed]
PHST- 2020/09/09 06:00 [medline]
PHST- 2020/08/21 00:00 [pmc-release]
AID - 00005792-202008210-00018 [pii]
AID - MD-D-20-02055 [pii]
AID - 10.1097/MD.0000000000021571 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2020 Aug 21;99(34):e21571. doi: 
      10.1097/MD.0000000000021571.