Patrick Daly

Cancer Nursing Today nonprod

The use of antithymocyte globulin (ATG) for graft-versus-host disease (GVHD) prophylaxis has led to a similar rate of chronic GVHD (cGVHD) between hematopoietic cell transplantations (HCT) with haploidentical donors (HIDs) and human leukocyte antigen (HLA)-matched sibling donors (MSDs).However, the incidence of bronchiolitis obliterans syndrome (BOS)&mdash;effectively lung cGVHD&mdash;between donor types is unclear, according to authors in <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2022.1036403/full" target="_blank" rel="noopener">Frontiers in Immunology</a>. In their study, the investigators reported that patients who received HCT with graft sourced from a HID appeared to have a lower incidence of BOS compared with MSD transplants, which the authors suggested may be due to ATG and use of mixed grafts.<h3>HUD HCT Shows Lower Rates of Pulmonary GVHD</h3>Their findings were based on retrospective analyses of 1,405 patients with hematologic malignancies who underwent HCT. Patients were stratified according to donor type (HID, MSD, or matched-unrelated donor [MUD]), and researchers examined rates and risk factors of BOS.Reportedly, the overall cohort had a 5-year cumulative incidence of BOS of 7.2%. Patients who received HID transplantation had a lower 5-year cumulative incidence compared with MSD transplantation (4.1% vs. 10.0%; P&lt;.001) and a similar incidence compared with MUD (4.1% vs. 6.2%; P=.224).Researchers found bronchiolitis obliterans syndrome was less frequent in HCT with haploidentical donors compared with MSD and MUDS.In addition, patients who received ATG had a lower 5-year cumulative incidence of BOS compared with non-ATG patients in the overall cohort (4.6% vs. 11.2%; P&lt;.001) and in the MSD group (4.1 vs. 11.2; P=.042).Patients with mixed&ndash;peripheral-blood stem cell plus bone marrow grafts had a lower 5-year cumulative incidence of BOS compared with those patients with only peripheral-blood stem cell grafts (4.2% vs. 9.1%; P=.001).Protective factors for BOS included HID (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.2-0.6; P&lt;.001), use of ATG (OR, 0.3; 95% CI, 0.2-0.7; P=.001), and mixed graft source (OR, 0.3; 95% CI, 0.1-0.8; P=.013).Comparatively, risk factors for BOS included acute GVHD (OR, 2.1; 95% CI 1.1-4.3; P=.035) and any cGVHD (OR, 10.1, 95% CI, 4.0-25.0; P&lt;.001).&ldquo;In conclusion,&rdquo; the authors summarized, &ldquo;we suggested that HID transplantation based on ATG for GVHD prophylaxis presented a lower incidence of BOS than MSD transplantation. This study might provide a potential strategy for preventing BOS posttransplantation regardless of HID, MUD, or MSD transplantation.&rdquo;Read More <a href="https://cancernursingtoday.com/page/gvhd">GVHD Research</a>

Comparing BOS Incidence Between HCT Donor Types

GVHD

Researchers found bronchiolitis obliterans syndrome was less frequent in HCT with HID donors compared with MSD and MUDs.

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