IMPACT OF CYCLOSPORINE-A CONCENTRATION IN T CELL-REPLETE HAPLOIDENTICAL ALLOGENEIC STEM CELL TRANSPLANTATION
(Abstract release date: 05/19/16)
EHA Library. Yang X. 06/09/16; 133078; E1529
Prof. Dr. Xiaofei Yang
Contributions
Contributions
Abstract
Abstract: E1529
Type: Eposter Presentation
Background
Previous studies on HLA-identical allo-HSCT (allogeneic hematopoietic stem cell transplantation) have shown that level of blood CSA concentration during early stage after HSCT were significantly associated with risk of severe aGVHD (acute graft versus host disease). However, there remains a lack of data on T cell-replete haploidentical HSCT in which using ATG combined with CSA, MTX, MMF to prevent GVHD. Objective: This study was to investigate whether CSA (cyclosporine-A) levels impact on clinical outcomes of patients in the T cell-replete haploidentical allo-HSCT setting.
Aims
This study was to investigate whether CSA (cyclosporine-A) levels impact on clinical outcomes of patients in the T cell-replete haploidentical allo-sct (allogeneic stem cell transplantation) setting.
Methods
we retrospectively analyzed 140 consecutive patients who conducted T cell-replete haploidentical allo-sct in our institution to assess effect of CSA concentration in early stage on clinical outcomes including hematopoietic recovery, aGVHD (acute graft versus host disease), infection, DFS (disease free survival), and OS (overall survival).
Results
The median concentrations of CSA in the blood in the 1st, 2nd, 3rd and 4th week after allo-sct were 218ng/ml (rang:54-1377ng/ml ), 235ng/ml (rang:27-1500ng/ml ), 263ng/ml (rang:20-1500ng/ml ), and 270ng/ml (rang:4-1500ng/ml ); 46%, 40%, 27% and 18% of the patients had CsA blood levels below 200 ng/mL during these weeks. 39 patients developed grade 2–4 aGVHD for a cumulative incidence of 27.8% at a median of 32 days.CSA levels during 1st, 2nd, and 4th week didn’t affect patients’ hematopoietic recovery, aGVHD, infection, DFS, and OS significantly (p>0.05). However, patients having CSA concentration below 200ng/ml in the 3rd week had a higher cumulative incidence of grade 2-4 aGVHD (p=0.02). In a multivariate logistic regression analysis, low CSA concentration (below 200ng/ml) in the 3rd week remained the independent risk factor of grade 2-4 aGVHD (p=0.02). CSA level in the 3rd week was not associated with patients’ engraftment, infection, DFS, and OS (p>0.05).
Conclusion
The analysis presented here emphasize that adequate management of CSA levels in the early stage, especially during the periengrafment period, can improve clinical outcomes in the T cell-replete haploidentical allo-sct setting.
Session topic: E-poster
Keyword(s): Cyclosporin A, Haploidentical stem cell transplantation
Type: Eposter Presentation
Background
Previous studies on HLA-identical allo-HSCT (allogeneic hematopoietic stem cell transplantation) have shown that level of blood CSA concentration during early stage after HSCT were significantly associated with risk of severe aGVHD (acute graft versus host disease). However, there remains a lack of data on T cell-replete haploidentical HSCT in which using ATG combined with CSA, MTX, MMF to prevent GVHD. Objective: This study was to investigate whether CSA (cyclosporine-A) levels impact on clinical outcomes of patients in the T cell-replete haploidentical allo-HSCT setting.
Aims
This study was to investigate whether CSA (cyclosporine-A) levels impact on clinical outcomes of patients in the T cell-replete haploidentical allo-sct (allogeneic stem cell transplantation) setting.
Methods
we retrospectively analyzed 140 consecutive patients who conducted T cell-replete haploidentical allo-sct in our institution to assess effect of CSA concentration in early stage on clinical outcomes including hematopoietic recovery, aGVHD (acute graft versus host disease), infection, DFS (disease free survival), and OS (overall survival).
Results
The median concentrations of CSA in the blood in the 1st, 2nd, 3rd and 4th week after allo-sct were 218ng/ml (rang:54-1377ng/ml ), 235ng/ml (rang:27-1500ng/ml ), 263ng/ml (rang:20-1500ng/ml ), and 270ng/ml (rang:4-1500ng/ml ); 46%, 40%, 27% and 18% of the patients had CsA blood levels below 200 ng/mL during these weeks. 39 patients developed grade 2–4 aGVHD for a cumulative incidence of 27.8% at a median of 32 days.CSA levels during 1st, 2nd, and 4th week didn’t affect patients’ hematopoietic recovery, aGVHD, infection, DFS, and OS significantly (p>0.05). However, patients having CSA concentration below 200ng/ml in the 3rd week had a higher cumulative incidence of grade 2-4 aGVHD (p=0.02). In a multivariate logistic regression analysis, low CSA concentration (below 200ng/ml) in the 3rd week remained the independent risk factor of grade 2-4 aGVHD (p=0.02). CSA level in the 3rd week was not associated with patients’ engraftment, infection, DFS, and OS (p>0.05).
Conclusion
The analysis presented here emphasize that adequate management of CSA levels in the early stage, especially during the periengrafment period, can improve clinical outcomes in the T cell-replete haploidentical allo-sct setting.
Session topic: E-poster
Keyword(s): Cyclosporin A, Haploidentical stem cell transplantation
Abstract: E1529
Type: Eposter Presentation
Background
Previous studies on HLA-identical allo-HSCT (allogeneic hematopoietic stem cell transplantation) have shown that level of blood CSA concentration during early stage after HSCT were significantly associated with risk of severe aGVHD (acute graft versus host disease). However, there remains a lack of data on T cell-replete haploidentical HSCT in which using ATG combined with CSA, MTX, MMF to prevent GVHD. Objective: This study was to investigate whether CSA (cyclosporine-A) levels impact on clinical outcomes of patients in the T cell-replete haploidentical allo-HSCT setting.
Aims
This study was to investigate whether CSA (cyclosporine-A) levels impact on clinical outcomes of patients in the T cell-replete haploidentical allo-sct (allogeneic stem cell transplantation) setting.
Methods
we retrospectively analyzed 140 consecutive patients who conducted T cell-replete haploidentical allo-sct in our institution to assess effect of CSA concentration in early stage on clinical outcomes including hematopoietic recovery, aGVHD (acute graft versus host disease), infection, DFS (disease free survival), and OS (overall survival).
Results
The median concentrations of CSA in the blood in the 1st, 2nd, 3rd and 4th week after allo-sct were 218ng/ml (rang:54-1377ng/ml ), 235ng/ml (rang:27-1500ng/ml ), 263ng/ml (rang:20-1500ng/ml ), and 270ng/ml (rang:4-1500ng/ml ); 46%, 40%, 27% and 18% of the patients had CsA blood levels below 200 ng/mL during these weeks. 39 patients developed grade 2–4 aGVHD for a cumulative incidence of 27.8% at a median of 32 days.CSA levels during 1st, 2nd, and 4th week didn’t affect patients’ hematopoietic recovery, aGVHD, infection, DFS, and OS significantly (p>0.05). However, patients having CSA concentration below 200ng/ml in the 3rd week had a higher cumulative incidence of grade 2-4 aGVHD (p=0.02). In a multivariate logistic regression analysis, low CSA concentration (below 200ng/ml) in the 3rd week remained the independent risk factor of grade 2-4 aGVHD (p=0.02). CSA level in the 3rd week was not associated with patients’ engraftment, infection, DFS, and OS (p>0.05).
Conclusion
The analysis presented here emphasize that adequate management of CSA levels in the early stage, especially during the periengrafment period, can improve clinical outcomes in the T cell-replete haploidentical allo-sct setting.
Session topic: E-poster
Keyword(s): Cyclosporin A, Haploidentical stem cell transplantation
Type: Eposter Presentation
Background
Previous studies on HLA-identical allo-HSCT (allogeneic hematopoietic stem cell transplantation) have shown that level of blood CSA concentration during early stage after HSCT were significantly associated with risk of severe aGVHD (acute graft versus host disease). However, there remains a lack of data on T cell-replete haploidentical HSCT in which using ATG combined with CSA, MTX, MMF to prevent GVHD. Objective: This study was to investigate whether CSA (cyclosporine-A) levels impact on clinical outcomes of patients in the T cell-replete haploidentical allo-HSCT setting.
Aims
This study was to investigate whether CSA (cyclosporine-A) levels impact on clinical outcomes of patients in the T cell-replete haploidentical allo-sct (allogeneic stem cell transplantation) setting.
Methods
we retrospectively analyzed 140 consecutive patients who conducted T cell-replete haploidentical allo-sct in our institution to assess effect of CSA concentration in early stage on clinical outcomes including hematopoietic recovery, aGVHD (acute graft versus host disease), infection, DFS (disease free survival), and OS (overall survival).
Results
The median concentrations of CSA in the blood in the 1st, 2nd, 3rd and 4th week after allo-sct were 218ng/ml (rang:54-1377ng/ml ), 235ng/ml (rang:27-1500ng/ml ), 263ng/ml (rang:20-1500ng/ml ), and 270ng/ml (rang:4-1500ng/ml ); 46%, 40%, 27% and 18% of the patients had CsA blood levels below 200 ng/mL during these weeks. 39 patients developed grade 2–4 aGVHD for a cumulative incidence of 27.8% at a median of 32 days.CSA levels during 1st, 2nd, and 4th week didn’t affect patients’ hematopoietic recovery, aGVHD, infection, DFS, and OS significantly (p>0.05). However, patients having CSA concentration below 200ng/ml in the 3rd week had a higher cumulative incidence of grade 2-4 aGVHD (p=0.02). In a multivariate logistic regression analysis, low CSA concentration (below 200ng/ml) in the 3rd week remained the independent risk factor of grade 2-4 aGVHD (p=0.02). CSA level in the 3rd week was not associated with patients’ engraftment, infection, DFS, and OS (p>0.05).
Conclusion
The analysis presented here emphasize that adequate management of CSA levels in the early stage, especially during the periengrafment period, can improve clinical outcomes in the T cell-replete haploidentical allo-sct setting.
Session topic: E-poster
Keyword(s): Cyclosporin A, Haploidentical stem cell transplantation
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