Absence of post-transplantation lymphoproliferative disorder after allogeneic blood or marrow transplantation using post-transplantation cyclophosphamide as graft-versus-host disease prophylaxis

Biol Blood Marrow Transplant. 2013 Oct;19(10):1514-7. doi: 10.1016/j.bbmt.2013.07.013. Epub 2013 Jul 18.

Abstract

Immunosuppressive regimens that effectively prevent graft-versus-host disease (GVHD) after allogeneic blood or marrow transplantation (allo-BMT) have been associated with an increased incidence of post-transplantation lymphoproliferative disorder (PTLD) in the first year after transplantation. We evaluated the incidence of PTLD associated with the use of high-dose post-transplantation cyclophosphamide (PTCy) as GVHD prophylaxis. Between 2000 and 2011, a total of 785 adult allo-BMT recipients were given PTCy as GVHD prophylaxis at the Johns Hopkins Hospital, including 313 patients who received PTCy as sole GVHD prophylaxis. HLA-haploidentical or unrelated donor graft transplantation was performed in 526 patients (67%). No cases of PTLD occurred during the first year after allo-BMT in this series. PTLD is a rare occurrence after allo-BMT using PTCy, even in high-risk alternative donor transplantations.

Keywords: Allogeneic blood or marrow transplantation; Graft-versus-host disease prophylaxis; Post-transplantation cyclophosphamide; Post-transplantation lymphoproliferative disorder.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Bone Marrow Transplantation / methods*
  • Cyclophosphamide / therapeutic use*
  • Female
  • Graft vs Host Disease / drug therapy
  • Graft vs Host Disease / prevention & control*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lymphoma / drug therapy
  • Lymphoma / surgery
  • Lymphoma / therapy*
  • Male
  • Middle Aged
  • Transplantation, Homologous / methods*
  • Young Adult

Substances

  • Antineoplastic Agents, Alkylating
  • Immunosuppressive Agents
  • Cyclophosphamide