Safety and Efficacy of Haploidentical Peripheral Blood Stem Cell Transplantation for Myeloid Malignancies Using Post-transplantation Cyclophosphamide and Anti-thymocyte Globulin as Graft-versus-Host Disease Prophylaxis
Bibliographic record
Abstract
Haploidentical hematopoietic cell transplantation T-cell replete grafts Post-transplant cyclophosphamide Anti-thymocyte globulin Myeloid malignancies Graft-versus-host disease A B S T R A C THaploidentical stem cell transplantation (haploSCT) has greatly improved access to curative treatment for myeloid malignancies in patients without suitable matched sibling/unrelated donors.We investigated the safety and efficacy of haploSCT after reduced intensity conditioning (RIC) with anti-thymocyte globulin (ATG), post-transplant cyclophosphamide (PTCy), and cyclosporine to prevent rejection and graft-versus-host disease (GVHD).In this study, 47 patients received RIC using fludarabine, busulfan, and total body irradiation (200 cGy).Unmanipulated peripheral blood grafts were used.GVHD prophylaxis included ATG (4.5 mg/kg day-3 to -1), PTCy (50 mg/kg/day day +3, +4), and cyclosporine from day +5.The median follow-up was 15 months (range 3-27).Thirty one (66%) patients had acute myeloid leukemia (AML), 10 (21%) had high-risk myelodysplastic syndrome, and 6 (13%) had a myeloproliferative neoplasia.Median age was 60 years (range 22-73).The d+100 cumulative incidences of grade II-IV and III-IV acute GVHD were 17% (95% confidence interval (CI) 7.9-29.1)and 6.4% (1.6-15.9),respectively.The cumulative incidence of moderate-severe chronic GVHD at 1 year was 15.2% (95% CI 6.5-27.1).Overall survival (OS) and relapse-free survival (RFS) were 55.2% (95% CI 39.5-68.4) and 49.5% (95% CI 34.2-63), respectively.Nonrelapse mortality (NRM) for all patients at 1 year was 37.1% (95% CI 23.2-51.1).Infection was the main cause of death (26%).For AML, 1-year OS, RFS, and NRM were 64.1% (95% CI 43.3-78.9),54.5 (95% CI 34.6-70.7),and 26.8% (95% CI 12.3-43.6),respectively.In conclusion, unmanipulated haploidentical peripheral blood stem cells (PBSC) transplantation following RIC and dual in vivo T-cell depletion results in a low incidence of acute and chronic GVHD for patients diagnosed with myeloid malignancies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".