title: Low incidence of acute graft-versus-host disease with short-term tacrolimus in haploidentical hematopoietic stem cell transplantation.
abstract: Although tacrolimus (Tac) has immunosuppressive properties and exhibits promising efficacy against graft-versus-host disease (GVHD), little is known about Tac in the prophylaxis of GVHD after HLA-haploidentical hematopoietic stem cell transplantation (haplo-HSCT). In a multicenter randomized controlled trial, 174 patients received haplo-HSCT with GVHD prophylaxis involving short-term Tac (from -8days to +30days) or cyclosporine (CsA). The 100day cumulative incidences of acute GVHD (aGVHD) and grade III-IV aGVHD with the short-term Tac regimen and CsA regimen were 29.1 (19.5-38.7)% vs. 50.0(39.6-60.4)% (p=0.005) and 3.6(0.0-7.5)% vs. 13.5(6.1-20.9)% (p=0.027), respectively. There were no significant differences in the incidences of chronic GVHD (cGVHD), relapse and cytomegalovirus infection. Lymphocyte subset analysis showed that T cells decreased to lower levels on the short-term Tac regimen within 3 months of transplantation. The disease-free survival and overall survival on the short-term Tac and CsA regimens were 59.3 (48.9-69.7)% vs. 55.7 (45.3-66.1)% (p=0.696) and 65.1 (55.1-75.1)% vs. 61.4 (51.2-71.6)% (p=0.075), respectively. Our findings indicate that the short-term Tac regimen for GVHD prophylaxis in patients undergoing haplo-HSCT is associated with a low incidence and slight severity of aGVHD and did not increase the incidence of relapse and cytomegalovirus infection.
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China. Electronic address: gaolei7765@163.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Health Statistics, College of Military Preventive Medicine, Third Military Medical University, Chongqing, China.
authors.forename: Yanqi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Xinghua
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Peiyan
authors.initials: P
authors.lastname: Kong
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
authors.forename: Jiangfan
authors.initials: J
authors.lastname: Zhong
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Aihua
authors.initials: A
authors.lastname: Sun
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Hematology, General Hospital of Chengdu Military Region of PLA, Chengdu, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Su
authors.affiliation: Department of Hematology, Affiliated Hospital of Kunming Medical College, Kunming, China.
authors.forename: Huimin
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Xiangui
authors.initials: X
authors.lastname: Peng
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China. Electronic address: zhangxxi@sina.com.
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D016572:Cyclosporine / Q000008:administration & dosage; D003586:Cytomegalovirus Infections; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control*; D006239:Haplotypes; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D011292:Premedication; D012008:Recurrence; D015996:Survival Rate; D016559:Tacrolimus / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D016572:Cyclosporine; D016559:Tacrolimus
keywords: Graft-versus-host disease; Haploidentical; Hematopoietic stem cell transplantation; Tacrolimus