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PTCy- vs Tac-based regimens for cutaneous sclerotic cGvHD prophylaxis
Results from a single-center, retrospective cohort study, comparing post-transplant cyclophosphamide (PTCy)- vs tacrolimus (Tac)-based regimens for cutaneous sclerotic chronic graft-versus-host disease (cGvHD) prophylaxis in allogeneic hematopoietic cell transplantation (allo-HSCT) recipients (N = 581), were published in the Journal of the American Academy of Dermatology by Peacker et al. The incidence of sclerotic cGvHD was evaluated in patients treated with Tac + sirolimus (Sir; n = 60), Tac + methotrexate (MTX; n = 376), or PTCy + Tac + mycophenolate mofetil (MMF; n = 145).
Key data: Median time to cutaneous sclerotic cGvHD onset was 26 months (interquartile range [IQR], 17–34). At 5 years, the cumulative incidence of cutaneous sclerotic cGvHD was 27% (95% confidence interval [CI], 16–39), 17% (95% CI, 13–21), and 5.8% (95% CI, 2.5–11) with Tac + Sir, Tac + MTX, and PTCy + Tac + MMF prophylaxis, respectively (p < 0.001). In multivariable analyses, PTCy + Tac + MMF was associated with a lower incidence of cutaneous sclerotic cGvHD (subdistribution hazard ratio [SDHR], 0.09; 95% CI, 0.02–0.41; p = 0.002) and cGvHD (SDHR, 0.48; 95% CI, 0.30–0.76; p = 0.002) vs Tac + MTX.
Key learning: PTCy-based prophylaxis reduces the incidence of cutaneous sclerotic cGvHD following allo-HSCT compared with traditional Tac-based regimens.
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