在霍奇金淋巴瘤 (HL) 患者中，比较移植后环磷酰胺 (PTCy) 与传统的基于钙调磷酸酶抑制剂 (CNI) 的 GVHD 预防方案的疗效的研究很少。本研究旨在使用 2015 年 1 月至 2022 年 12 月期间向 EBMT 数据库报告的数据，比较接受来自 HLA 匹配供体的造血干细胞移植的 HL 患者的结果，这些患者接受了基于 PTCy 或传统 CNI 方案的 GVHD 预防。在该队列中，270 名接受者接受了基于 CNI 的传统预防，176 名接受者接受了 PTCy 预防。值得注意的是，与基于 CNI 的预防相比，PTCy 预防与造血恢复延迟相关，但也具有较低的慢性 GVHD 风险（25% 与 43%，p<0.001）和广泛慢性 GVHD（13% 与 28%，p=0.003）。队列。基于 PTCy 和 CNI 的 2 年累积非复发死亡率和复发发生率分别为 11% 和 17% (p=0.12) 以及 17% 和 30% (p=0.007)。此外，与基于 CNI 的组相比，PTCy 组的 2 年总生存率、无进展生存率和无 GVHD、无复发生存率均显着更好：85% 对比 72% (p=0.005)，72分别为 % 与 53% (p<0.001) 和 59% 与 31% (p<0.001)。在多变量分析中，与基于 CNI 的平台相比，PTCy 与较低的慢性和广泛慢性 GVHD 风险、减少的复发以及更好的 OS、PFS 和 GRFS 相关。我们的研究结果表明，对于接受 HLA 匹配供体的 HSCT 的成年 HL 患者，与传统的基于 CNI 的预防相比，PTCy 作为 GVHD 预防可提供更有利的结果。版权所有 © 2024 美国血液学会。

Studies comparing the efficacy of post-transplant cyclophosphamide (PTCy) to conventional calcineurin inhibitor (CNI)-based GVHD prophylaxis regimens in Hodgkin lymphoma (HL) patients are scarce. This study aimed to compare the outcomes of HL patients undergoing hematopoietic stem cell transplantation from HLA-matched donors who received GVHD prophylaxis with either PTCy or conventional CNI-based regimens, using data reported to the EBMT database between January 2015 and December 2022. Among the cohort, 270 recipients received conventional CNI-based prophylaxis and 176 received PTCy prophylaxis. Notably, PTCy prophylaxis was associated with delayed hematopoietic recovery, but also with a lower risk of chronic (25% versus 43%, p<0.001) and extensive chronic GVHD (13% versus 28% p=0.003) compared to the CNI-based cohort. The 2-year cumulative incidence of non-relapse mortality and relapse were 11% versus 17% (p=0.12), and 17% versus 30% (p=0.007) for PTCy and CNI-based, respectively. Moreover, the 2-year overall survival, progression-free survival and GVHD-free, relapse-free survival were all significantly better in the PTCy group compared with the CNI-based group: 85% versus 72% (p=0.005), 72% versus 53% (p<0.001), and 59% versus 31% (p<0.001), respectively. In multivariable analysis, PTCy was associated with a lower risk of chronic and extensive chronic GVHD, reduced relapse, and better OS, PFS, and GRFS compared to the CNI-based platform. Our findings suggest that PTCy as GVHD prophylaxis offers more favorable outcomes compared to conventional CNI-based prophylaxis in adult patients with HL undergoing HSCT from HLA-matched donors.Copyright © 2024 American Society of Hematology.