PMID- 36878730 OWN - NLM STAT- MEDLINE DCOM- 20231127 LR - 20231127 IS - 1445-5994 (Electronic) IS - 1444-0903 (Linking) VI - 53 IP - 11 DP - 2023 Nov TI - Long-term outcomes of corticosteroid graft versus host disease prophylaxis in peripheral blood allogeneic haemopoietic stem cell transplant: a comparative cohort analysis. PG - 1979-1986 LID - 10.1111/imj.16043 [doi] AB - BACKGROUND: Corticosteroids (CSs) have previously been incorporated into graft versus host disease (GVHD) prophylaxis regimens for bone marrow (BM) and haemopoietic stem cell transplant (HSCT). AIMS: To assess the impact of prophylactic CS in HSCT using peripheral blood (PB) stem cells. METHODS: Patients were identified from three HSCT centres receiving a first PB-HSCT between January 2011 and December 2015 from a fully human leukocyte antigen (HLA)-matched sibling or unrelated donor for acute myeloid leukaemia or acute lymphoblastic leukaemia. To enable meaningful comparison, patients were divided into two cohorts. RESULTS: Cohort 1 included only myeloablative-matched sibling HSCT, where the only variation in GVHD prophylaxis was the addition of CS. In these 48 patients, there were no differences in GVHD, relapse, non-relapse mortality, overall survival or GVHD-relapse-free-survival (GRFS) at 4 years after transplant. Cohort 2 included the remaining HSCT recipients, where one group received CS-prophylaxis and the non-CS group received an antimetabolite, ciclosporin and anti-T-lymphocyte globulin. In these 147 patients, those receiving CS-prophylaxis experienced higher rates of chronic GVHD (71% vs 18.1%, P < 0.001) and lower rates of relapse (14.9% vs 33.9%, P = 0.02). Those receiving CS-prophylaxis had a lower 4-year GRFS (15.7% vs 40.3%, P = 0.002). CONCLUSIONS: There does not appear to be a role for adding CS to standard GVHD prophylaxis regimens in PB-HSCT. CI - (c) 2023 The Authors. Internal Medicine Journal published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Physicians. FAU - Blennerhassett, Richard AU - Blennerhassett R AUID- ORCID: 0000-0001-6359-1950 AD - Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia. AD - School of Clinical Medicine, University of NSW Medicine and Health, Sydney, New South Wales, Australia. FAU - Othman, Jad AU - Othman J AUID- ORCID: 0000-0002-4971-3576 AD - Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia. AD - Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. FAU - Biscoe, Amber AU - Biscoe A AD - Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia. FAU - Kliman, David AU - Kliman D AD - Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia. FAU - Mills, Georgia AU - Mills G AD - Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia. AD - School of Clinical Medicine, University of NSW Medicine and Health, Sydney, New South Wales, Australia. FAU - Blyth, Emily AU - Blyth E AD - Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. AD - Blood Transplant and Cell Therapies Program, Westmead Hospital, Sydney, New South Wales, Australia. FAU - Micklethwaite, Kenneth AU - Micklethwaite K AD - Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. AD - Blood Transplant and Cell Therapies Program, Westmead Hospital, Sydney, New South Wales, Australia. FAU - Kwan, John AU - Kwan J AD - Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. AD - Blood Transplant and Cell Therapies Program, Westmead Hospital, Sydney, New South Wales, Australia. FAU - Bilmon, Ian AU - Bilmon I AD - Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. AD - Blood Transplant and Cell Therapies Program, Westmead Hospital, Sydney, New South Wales, Australia. FAU - Bhattacharyya, Abir AU - Bhattacharyya A AD - Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. AD - Blood Transplant and Cell Therapies Program, Westmead Hospital, Sydney, New South Wales, Australia. FAU - Panicker, Shyam AU - Panicker S AD - Blood Transplant and Cell Therapies Program, Westmead Hospital, Sydney, New South Wales, Australia. FAU - Fay, Keith AU - Fay K AD - Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia. AD - Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia. FAU - Milliken, Sam AU - Milliken S AD - Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia. AD - School of Clinical Medicine, University of NSW Medicine and Health, Sydney, New South Wales, Australia. FAU - Ma, David AU - Ma D AD - Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia. AD - School of Clinical Medicine, University of NSW Medicine and Health, Sydney, New South Wales, Australia. FAU - Hamad, Nada AU - Hamad N AUID- ORCID: 0000-0001-7929-1450 AD - Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia. AD - School of Clinical Medicine, University of NSW Medicine and Health, Sydney, New South Wales, Australia. AD - School of Medicine, University of Notre Dame Australia, School of Medicine, Sydney, New South Wales, Australia. FAU - Stevenson, William AU - Stevenson W AD - Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia. AD - Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. FAU - Arthur, Chris AU - Arthur C AUID- ORCID: 0000-0002-9147-9090 AD - Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia. FAU - Moore, John AU - Moore J AD - Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia. AD - School of Clinical Medicine, University of NSW Medicine and Health, Sydney, New South Wales, Australia. FAU - Greenwood, Matthew AU - Greenwood M AUID- ORCID: 0000-0002-3667-2613 AD - Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia. AD - Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. FAU - Gottlieb, David AU - Gottlieb D AD - Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. AD - Blood Transplant and Cell Therapies Program, Westmead Hospital, Sydney, New South Wales, Australia. FAU - Kerridge, Ian AU - Kerridge I AD - Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia. AD - Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. LA - eng PT - Journal Article DEP - 20230321 PL - Australia TA - Intern Med J JT - Internal medicine journal JID - 101092952 RN - 0 (Adrenal Cortex Hormones) SB - IM MH - Humans MH - Neoplasm Recurrence, Local MH - *Hematopoietic Stem Cell Transplantation MH - *Graft vs Host Disease/prevention & control MH - *Peripheral Blood Stem Cell Transplantation MH - Adrenal Cortex Hormones/therapeutic use MH - Cohort Studies MH - Recurrence MH - Retrospective Studies EDAT- 2023/03/07 06:00 MHDA- 2023/11/27 12:43 CRDT- 2023/03/06 21:52 PHST- 2022/12/23 00:00 [received] PHST- 2023/02/12 00:00 [accepted] PHST- 2023/11/27 12:43 [medline] PHST- 2023/03/07 06:00 [pubmed] PHST- 2023/03/06 21:52 [entrez] AID - 10.1111/imj.16043 [doi] PST - ppublish SO - Intern Med J. 2023 Nov;53(11):1979-1986. doi: 10.1111/imj.16043. Epub 2023 Mar 21.