Characterization of Chronic Graft-versus-host Disease After Haploidentical Stem Cell Transplantation With...

Area of Science:

• Hematology
• Transplantation Immunology
• Oncology

Background:

• Chronic graft-versus-host disease (cGVHD) is a significant cause of morbidity and nonrelapse mortality following allogeneic hematopoietic stem cell transplantation (allo-HSCT).
• While haploidentical allo-HSCT (haplo-HSCT) with posttransplant cyclophosphamide (PTCy) shows promise in reducing cGVHD rates, comprehensive data on its clinical profile, risk factors, and outcomes remain limited.

Purpose of the Study:

• To analyze the incidence, clinical characteristics, risk factors, and outcomes of cGVHD in patients undergoing haplo-HSCT with PTCy.
• To compare cGVHD rates and severity with those reported for HLA-identical transplantation.

Main Methods:

• A retrospective multicenter analysis was conducted on 389 patients who received haplo-HSCT with PTCy between 2008 and 2020.
• Data on cGVHD incidence, clinical profile, risk factors, and patient outcomes were collected from seven transplant centers.

Main Results:

• The incidence and severity of cGVHD were lower compared to HLA-identical transplantation.
• Previous acute GVHD was the strongest predictor of cGVHD (P=0.031), while recipient age ≥60 years was protective (P=0.044).
• Patients with moderate cGVHD exhibited longer event-free survival (P=0.016) and lower relapse rates (P=0.036) at 3 years.

Conclusions:

• Haplo-HSCT with PTCy is associated with reduced incidence and severity of cGVHD compared to conventional prophylaxis.
• Moderate cGVHD in this context may indicate a stronger graft-versus-leukemia effect, leading to improved survival outcomes.
• Further prospective studies are warranted to validate these findings.