Tacrolimus versus Cyclosporine after Hematopoietic Cell Transplantation for Acquired Aplastic Anemia

Yoshihiro Inamoto; Mary E.D. Flowers; Tao Wang; Alvaro Urbano-Ispizua; Michael T. Hemmer; Corey S. Cutler; Daniel R. Couriel; Amin M. Alousi; Joseph H. Antin; Robert Peter Gale; Vikas Gupta; Betty K. Hamilton; Mohamed A. Kharfan-Dabaja; David I. Marks; Olle T.H. Ringdén; Gérard Socié; Melhem M. Solh; Görgün Akpek; Mitchell S. Cairo; Nelson J. Chao; Robert J. Hayashi; Taiga Nishihori; Ran Reshef; Ayman Saad; Ami Shah; Takanori Teshima; Martin S. Tallman; Baldeep Wirk; Stephen R. Spellman; Mukta Arora; Paul J. Martin

doi:10.1016/j.bbmt.2015.05.023

Tacrolimus versus Cyclosporine after Hematopoietic Cell Transplantation for Acquired Aplastic Anemia

Yoshihiro Inamoto
, Mary E.D. Flowers
, Tao Wang
, Alvaro Urbano-Ispizua
, Michael T. Hemmer
, Corey S. Cutler
, Daniel R. Couriel
, Amin M. Alousi
, Joseph H. Antin
, Robert Peter Gale
, Vikas Gupta
, Betty K. Hamilton
, Mohamed A. Kharfan-Dabaja
, David I. Marks
, Olle T.H. Ringdén
, Gérard Socié
, Melhem M. Solh
, Görgün Akpek
, Mitchell S. Cairo
, Nelson J. Chao

Robert J. Hayashi, Taiga Nishihori, Ran Reshef, Ayman Saad, Ami Shah, Takanori Teshima, Martin S. Tallman, Baldeep Wirk, Stephen R. Spellman, Mukta Arora, Paul J. Martin

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

Combinations of cyclosporine (CSP) with methotrexate (MTX) have been widely used for immunosuppression after allogeneic transplantation for acquired aplastic anemia. We compared outcomes with tacrolimus (TAC)+MTX versus CSP+MTX after transplantation from HLA-identical siblings (SIB) or unrelated donors (URD) in a retrospective cohort of 949 patients with severe aplastic anemia. Study endpoints included hematopoietic recovery, graft failure, acute graft-versus-host disease (GVHD), chronic GVHD, and mortality. TAC+MTX was used more frequently in older patients and, in recent years, in both SIB and URD groups. In multivariate analysis, TAC+MTX was associated with a lower risk of mortality in URD recipients and with slightly earlier absolute neutrophil count recovery in SIB recipients. Other outcomes did not differ statistically between the 2 regimens. No firm conclusions were reached regarding the relative merits of TAC+MTX versus CSP+MTX after hematopoietic cell transplantation for acquired aplastic anemia. Prospective studies would be needed to determine whether the use of TAC+MTX is associated with lower risk of mortality in URD recipients with acquired aplastic anemia.

Original language	English
Pages (from-to)	1776-1782
Number of pages	7
Journal	Biology of Blood and Marrow Transplantation
Volume	21
Issue number	10
DOIs	https://doi.org/10.1016/j.bbmt.2015.05.023
Publication status	Published - 01-10-2015
Externally published	Yes

All Science Journal Classification (ASJC) codes

Hematology
Transplantation

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10.1016/j.bbmt.2015.05.023

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Inamoto, Y., Flowers, M. E. D., Wang, T., Urbano-Ispizua, A., Hemmer, M. T., Cutler, C. S., Couriel, D. R., Alousi, A. M., Antin, J. H., Gale, R. P., Gupta, V., Hamilton, B. K., Kharfan-Dabaja, M. A., Marks, D. I., Ringdén, O. T. H., Socié, G., Solh, M. M., Akpek, G., Cairo, M. S., ... Martin, P. J. (2015). Tacrolimus versus Cyclosporine after Hematopoietic Cell Transplantation for Acquired Aplastic Anemia. Biology of Blood and Marrow Transplantation, 21(10), 1776-1782. https://doi.org/10.1016/j.bbmt.2015.05.023

@article{3b9d2b133f464944b3f7abf24e6bfb33,

title = "Tacrolimus versus Cyclosporine after Hematopoietic Cell Transplantation for Acquired Aplastic Anemia",

abstract = "Combinations of cyclosporine (CSP) with methotrexate (MTX) have been widely used for immunosuppression after allogeneic transplantation for acquired aplastic anemia. We compared outcomes with tacrolimus (TAC)+MTX versus CSP+MTX after transplantation from HLA-identical siblings (SIB) or unrelated donors (URD) in a retrospective cohort of 949 patients with severe aplastic anemia. Study endpoints included hematopoietic recovery, graft failure, acute graft-versus-host disease (GVHD), chronic GVHD, and mortality. TAC+MTX was used more frequently in older patients and, in recent years, in both SIB and URD groups. In multivariate analysis, TAC+MTX was associated with a lower risk of mortality in URD recipients and with slightly earlier absolute neutrophil count recovery in SIB recipients. Other outcomes did not differ statistically between the 2 regimens. No firm conclusions were reached regarding the relative merits of TAC+MTX versus CSP+MTX after hematopoietic cell transplantation for acquired aplastic anemia. Prospective studies would be needed to determine whether the use of TAC+MTX is associated with lower risk of mortality in URD recipients with acquired aplastic anemia.",

author = "Yoshihiro Inamoto and Flowers, \{Mary E.D.\} and Tao Wang and Alvaro Urbano-Ispizua and Hemmer, \{Michael T.\} and Cutler, \{Corey S.\} and Couriel, \{Daniel R.\} and Alousi, \{Amin M.\} and Antin, \{Joseph H.\} and Gale, \{Robert Peter\} and Vikas Gupta and Hamilton, \{Betty K.\} and Kharfan-Dabaja, \{Mohamed A.\} and Marks, \{David I.\} and Ringd{\'e}n, \{Olle T.H.\} and G{\'e}rard Soci{\'e} and Solh, \{Melhem M.\} and G{\"o}rg{\"u}n Akpek and Cairo, \{Mitchell S.\} and Chao, \{Nelson J.\} and Hayashi, \{Robert J.\} and Taiga Nishihori and Ran Reshef and Ayman Saad and Ami Shah and Takanori Teshima and Tallman, \{Martin S.\} and Baldeep Wirk and Spellman, \{Stephen R.\} and Mukta Arora and Martin, \{Paul J.\}",

note = "Publisher Copyright: {\textcopyright} 2015 American Society for Blood and Marrow Transplantation.",

year = "2015",

month = oct,

day = "1",

doi = "10.1016/j.bbmt.2015.05.023",

language = "English",

volume = "21",

pages = "1776--1782",

journal = "Biology of Blood and Marrow Transplantation",

issn = "1083-8791",

publisher = "Elsevier Inc.",

number = "10",

}

Inamoto, Y, Flowers, MED, Wang, T, Urbano-Ispizua, A, Hemmer, MT, Cutler, CS, Couriel, DR, Alousi, AM, Antin, JH, Gale, RP, Gupta, V, Hamilton, BK, Kharfan-Dabaja, MA, Marks, DI, Ringdén, OTH, Socié, G, Solh, MM, Akpek, G, Cairo, MS, Chao, NJ, Hayashi, RJ, Nishihori, T, Reshef, R, Saad, A, Shah, A, Teshima, T, Tallman, MS, Wirk, B, Spellman, SR, Arora, M & Martin, PJ 2015, 'Tacrolimus versus Cyclosporine after Hematopoietic Cell Transplantation for Acquired Aplastic Anemia', Biology of Blood and Marrow Transplantation, vol. 21, no. 10, pp. 1776-1782. https://doi.org/10.1016/j.bbmt.2015.05.023

TY - JOUR

T1 - Tacrolimus versus Cyclosporine after Hematopoietic Cell Transplantation for Acquired Aplastic Anemia

AU - Inamoto, Yoshihiro

AU - Flowers, Mary E.D.

AU - Wang, Tao

AU - Urbano-Ispizua, Alvaro

AU - Hemmer, Michael T.

AU - Cutler, Corey S.

AU - Couriel, Daniel R.

AU - Alousi, Amin M.

AU - Antin, Joseph H.

AU - Gale, Robert Peter

AU - Gupta, Vikas

AU - Hamilton, Betty K.

AU - Kharfan-Dabaja, Mohamed A.

AU - Marks, David I.

AU - Ringdén, Olle T.H.

AU - Socié, Gérard

AU - Solh, Melhem M.

AU - Akpek, Görgün

AU - Cairo, Mitchell S.

AU - Chao, Nelson J.

AU - Hayashi, Robert J.

AU - Nishihori, Taiga

AU - Reshef, Ran

AU - Saad, Ayman

AU - Shah, Ami

AU - Teshima, Takanori

AU - Tallman, Martin S.

AU - Wirk, Baldeep

AU - Spellman, Stephen R.

AU - Arora, Mukta

AU - Martin, Paul J.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Combinations of cyclosporine (CSP) with methotrexate (MTX) have been widely used for immunosuppression after allogeneic transplantation for acquired aplastic anemia. We compared outcomes with tacrolimus (TAC)+MTX versus CSP+MTX after transplantation from HLA-identical siblings (SIB) or unrelated donors (URD) in a retrospective cohort of 949 patients with severe aplastic anemia. Study endpoints included hematopoietic recovery, graft failure, acute graft-versus-host disease (GVHD), chronic GVHD, and mortality. TAC+MTX was used more frequently in older patients and, in recent years, in both SIB and URD groups. In multivariate analysis, TAC+MTX was associated with a lower risk of mortality in URD recipients and with slightly earlier absolute neutrophil count recovery in SIB recipients. Other outcomes did not differ statistically between the 2 regimens. No firm conclusions were reached regarding the relative merits of TAC+MTX versus CSP+MTX after hematopoietic cell transplantation for acquired aplastic anemia. Prospective studies would be needed to determine whether the use of TAC+MTX is associated with lower risk of mortality in URD recipients with acquired aplastic anemia.

AB - Combinations of cyclosporine (CSP) with methotrexate (MTX) have been widely used for immunosuppression after allogeneic transplantation for acquired aplastic anemia. We compared outcomes with tacrolimus (TAC)+MTX versus CSP+MTX after transplantation from HLA-identical siblings (SIB) or unrelated donors (URD) in a retrospective cohort of 949 patients with severe aplastic anemia. Study endpoints included hematopoietic recovery, graft failure, acute graft-versus-host disease (GVHD), chronic GVHD, and mortality. TAC+MTX was used more frequently in older patients and, in recent years, in both SIB and URD groups. In multivariate analysis, TAC+MTX was associated with a lower risk of mortality in URD recipients and with slightly earlier absolute neutrophil count recovery in SIB recipients. Other outcomes did not differ statistically between the 2 regimens. No firm conclusions were reached regarding the relative merits of TAC+MTX versus CSP+MTX after hematopoietic cell transplantation for acquired aplastic anemia. Prospective studies would be needed to determine whether the use of TAC+MTX is associated with lower risk of mortality in URD recipients with acquired aplastic anemia.

UR - https://www.scopus.com/pages/publications/84941315257

UR - https://www.scopus.com/pages/publications/84941315257#tab=citedBy

U2 - 10.1016/j.bbmt.2015.05.023

DO - 10.1016/j.bbmt.2015.05.023

M3 - Article

C2 - 26033280

AN - SCOPUS:84941315257

SN - 1083-8791

VL - 21

SP - 1776

EP - 1782

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

IS - 10

ER -

Tacrolimus versus Cyclosporine after Hematopoietic Cell Transplantation for Acquired Aplastic Anemia

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