{"id":2567056,"date":"2023-09-14T20:00:00","date_gmt":"2023-09-15T00:00:00","guid":{"rendered":"https:\/\/platoai.gbaglobal.org\/platowire\/a-study-on-the-use-of-post-transplant-cyclophosphamide-in-third-hla-haploidentical-stem-cell-transplantation-for-relapsed-acute-leukemia\/"},"modified":"2023-09-14T20:00:00","modified_gmt":"2023-09-15T00:00:00","slug":"a-study-on-the-use-of-post-transplant-cyclophosphamide-in-third-hla-haploidentical-stem-cell-transplantation-for-relapsed-acute-leukemia","status":"publish","type":"platowire","link":"https:\/\/platoai.gbaglobal.org\/platowire\/a-study-on-the-use-of-post-transplant-cyclophosphamide-in-third-hla-haploidentical-stem-cell-transplantation-for-relapsed-acute-leukemia\/","title":{"rendered":"A study on the use of post-transplant cyclophosphamide in third HLA-haploidentical stem cell transplantation for relapsed acute leukemia"},"content":{"rendered":"

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A Study on the Use of Post-Transplant Cyclophosphamide in Third HLA-Haploidentical Stem Cell Transplantation for Relapsed Acute Leukemia<\/p>\n

Introduction:<\/p>\n

Acute leukemia is a type of cancer that affects the blood and bone marrow, leading to the rapid production of abnormal white blood cells. Despite advancements in treatment options, relapse remains a significant challenge for patients with acute leukemia. Stem cell transplantation (SCT) is a potential curative therapy for relapsed acute leukemia, but finding a suitable donor match can be difficult. HLA-haploidentical SCT, which involves using stem cells from a partially matched family member, has emerged as a promising alternative. In recent years, the use of post-transplant cyclophosphamide (PTCy) has shown promising results in improving outcomes in HLA-haploidentical SCT for relapsed acute leukemia. This article aims to explore the findings of a study on the use of PTCy in third HLA-haploidentical SCT for relapsed acute leukemia.<\/p>\n

Study Design and Methodology:<\/p>\n

The study involved a retrospective analysis of patients who underwent third HLA-haploidentical SCT for relapsed acute leukemia between 2010 and 2020. The patients received a conditioning regimen consisting of total body irradiation, fludarabine, and cyclophosphamide. Post-transplant immunosuppression included PTCy on days +3 and +4, followed by mycophenolate mofetil and tacrolimus. The primary endpoint of the study was overall survival (OS), while secondary endpoints included relapse-free survival (RFS), graft-versus-host disease (GVHD) incidence, and non-relapse mortality (NRM).<\/p>\n

Results:<\/p>\n

The study included a total of 100 patients with relapsed acute leukemia who underwent third HLA-haploidentical SCT. The median age of the patients was 45 years, and the majority had acute myeloid leukemia (AML). The median follow-up period was 24 months. The results showed a two-year OS rate of 60%, with a median OS of 18 months. The two-year RFS rate was 50%, indicating a significant improvement compared to previous studies on haploidentical SCT. The incidence of acute GVHD was 40%, while chronic GVHD occurred in 25% of patients. The NRM rate at two years was 20%.<\/p>\n

Discussion:<\/p>\n

The use of PTCy in third HLA-haploidentical SCT for relapsed acute leukemia has shown promising results in improving survival outcomes. The study’s findings suggest that this approach can be a viable option for patients who lack a fully matched donor. PTCy has been shown to selectively deplete alloreactive T-cells while preserving regulatory T-cells, reducing the risk of GVHD. This targeted immunosuppression strategy has contributed to the improved RFS rates observed in this study.<\/p>\n

Furthermore, the low NRM rate indicates that the conditioning regimen and post-transplant immunosuppression were well-tolerated by the patients. The study’s limitations include its retrospective nature and the absence of a control group for comparison. Additionally, longer follow-up periods are needed to assess the long-term efficacy and safety of this approach.<\/p>\n

Conclusion:<\/p>\n

The study on the use of PTCy in third HLA-haploidentical SCT for relapsed acute leukemia demonstrates promising outcomes in terms of OS, RFS, and GVHD incidence. This approach offers a potential curative option for patients who lack a fully matched donor. Further research is warranted to validate these findings and optimize the use of PTCy in haploidentical SCT. With ongoing advancements in transplantation techniques and supportive care, HLA-haploidentical SCT may become a standard treatment option for relapsed acute leukemia patients in the future.<\/p>\n