COMPARISON OF INFECTIOUS COMPLICATIONS IN PATIENTS RECEIVING HIGH-DOSE CYCLOPHOSPHAMIDE AS GVHD AFTER TRANSPLANTATION FROM A 9/10 HLA-MATCHED UNRELATED DONOR WITH STANDARD GVHD PROPHYLAXIS AFTER TRANSPLANT FROM A FULL MATCHING DONOR Infection With PTCy Versus Standard GvHD Prophylaxis

Main Article Content

Selim SAYIN

Keywords

Allogeneic hematopoietic cell transplantation, Cyclophosphamide, hemorrhagic cystitis, infection, invasive fungal infection, Post Cyclophosphamide GVHD Prophylaxis

Abstract

Background: The aim of this study was to evaluate whether cyclophosphamide administered after allogeneic stem cell transplantation (ASCT) from 9/10 HLA-Matched Unrelated Donors (MMUD) increases the rates of bloodstream infections (BSI) (fungal, viral (CMV, BK, hepatitis), bacterial), infectious complications (hemorrhagic cystitis(HC)) and infection-related mortality compared to allogeneic stem cell transplantation from matched related donors (MRD).


Metods: This is a retrospective multicenter study. 45 MMUD ASCT patients who received posttransplant cyclophosphamide + methotrexate + calcineurin inhibitor compared with 45 MRD ASCT patients who received methotrexate + calcineurin inhibitor.


Results: Although there was a statistically significant prolongation of neutrophil engraftment time in the PTCy arm, there was no statistically significant difference in bacterial BSI frequencies between the groups (PTCy; 9(20%), control;8 (17.8%), p=0.778). The distribution of CMV infection in the first 100 days was similar (p=0.827) but the distribution of CMV infection rate between the 100th and 365th days, was observed more frequently in the control group (p=0.005). HC rates and their grades were similar in both groups (PTCy; 4 (8.8%), control;6 (13.3%) p=0.502). The rates of VZV infection and invasive aspergillosis were similar in the PTCy and control groups (13.3% in the PTCy, and 17.8% in the control group p=0.561). IRM rate was statistically similar in both groups (13.3% in the PTCy arm and 17.8% in the control arm)


Conclusions: The addition of PTCy to standard GvHD prophylaxis in MMUD ASCT does not lead to an increase in CMV reactivation, bacterial BSI, invasive fungal infection, viral hemorrhagic cystitis or infection-related mortality.

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