Bone marrow transplantation
September 12, 2026 · via Europe PMC
GVHD prophylaxis with PTCy, ATG, PTCy+ATG, or no in vivo T-cell depletion in RIC matched-donor PBSC transplantation for AML and MDS.
Coman T, Morisset S, Devillier R, +37 more, Michallet M.
AI summary — for doctors, generated from the abstract only
In reduced-intensity matched-donor transplants for AML/MDS, PTCy was associated with less severe acute GVHD than ATG, with similar relapse and non-relapse mortality.
What was studied
A retrospective French-Belgian-Swiss registry analysis of 3624 adults with AML or MDS undergoing first RIC matched related or unrelated PBSC allo-HCT (2014-2022), comparing PTCy, ATG, PTCy+ATG and no in vivo T-cell depletion.
Key findings
- Groups: ATG n=3286, NONE n=213, PTCy n=97, PTCy+ATG n=28
- PTCy associated with lower grade III-IV acute GVHD vs ATG (HR 0.44, p=0.026)
- Both PTCy and ATG associated with less extensive chronic GVHD vs no T-cell depletion, without affecting NRM or relapse
- 1-year OS, PFS and GRFS were 69.92%, 62.46% and 48.39% regardless of donor type or prophylaxis
Clinical relevance
Supports PTCy as a possible alternative to ATG in this setting, but the PTCy group was small and the data are retrospective; randomised trials are ongoing.
Who should care
Limitations
Retrospective registry design with markedly unbalanced group sizes (only 97 PTCy and 28 PTCy+ATG patients) and median follow-up of 16.6 months.
Registry data suggest PTCy may reduce severe acute GVHD compared with ATG in reduced-intensity matched-donor transplants.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Post-transplant cyclophosphamide (PTCy) has transformed graft-versus-host disease (GVHD) prophylaxis but its role in matched-donor reduced-intensity allogeneic hematopoietic cell transplantation (allo-HCT) remains uncertain. We retrospectively analyzed adults with AML or MDS reported to the French-Belgian-Swiss EBMT/SFGM-TC registry who received a first allo-HCT from a matched related (MRD) or matched unrelated donor (MUD) after reduced-intensity conditioning (RIC) with peripheral blood stem cells between 2014 and 2022. Among 3624 patients, GVHD prophylaxis comprised immunosuppressive agents without in vivo T cell depletion (NONE, n = 213), PTCy±immunosuppression (PTCy, n = 97), ATG±immunosuppression (ATG, n = 3 286), or PTCy+ATG±immunosuppression (PTCy+ATG, n = 28). In multivariable competing-risk models, PTCy was associated with a significant reduction of grade III-IV aGVHD compared to ATG (HR 0.44, p = 0.026). Both PTCy and ATG were associated with a lower incidence of extensive cGVHD vs NONE, without affecting NRM or relapse risk. With a median follow up of 16.6 months, the probability of 1-year OS, PFS and GRFS were 69.92%, 62.46% and 48.39%, regardless of donor type or GVHD prophylaxis group. These large, homogeneous registry data support PTCy as an effective alternative to ATG for GVHD prophylaxis in RIC MRD/MUD allo-HCT for AML/MDS, and provide a benchmark while ongoing randomized trials mature.
DOI
10.1038/s41409-026-03033-6
PMID
42732012
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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