7808a9d3d7777a701d44a0202b1b0644 329184.pdf 95f0e1954043c3ec0945553c5276ae4fd0e2efd7 329184.pdf 5fcec30224a444a03d17e5a725b46170ec3ca3b2ee2fbb94ff9dd7fe79ba3047 329184.pdf Title: Complications of Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide—A Prospective Study on Behalf of the EBMT Transplant Complications Working Party Subject: Background: Haploidentical hematopoietic cell transplantations (haplo-HCTs) with post-transplant cyclophosphamide (PT-Cy) are standard practice, but complications causing morbidity and mortality are not well described. Methods: The aim of this prospective non-interventional multicenter study was to document frequency of potential non-infectious and infection-related complications and main transplant outcomes after the first unmanipulated haplo-HCT with PT-Cy between 2017 and 2019 in 129 adult patients with hematological malignancies. The median follow-up was 37.3 months [95% CI: 34.3–39.7]. Results: The cumulative incidence (CI) of acute graft versus host disease (aGvHD) at day +100 was 22.4% grade II-IV [95% CI: 15.5–30.1] and 8.8% grade III-IV [95% CI: 4.6–14.6], respectively. The cumulative incidence of chronic GvHD (cGvHD) at 24 months was 25.8% [95% CI: 18.5–33.6]; extensive cGvHD was 10.9% [95% CI: 6.3–17.1], respectively. The most frequent non-infectious complications for the whole study population were mucositis—37.5% (n = 48); renal insufficiency—18% (n = 23); and cardiovascular complications—10.9% (n = 14). The following infection-related complications were diagnosed: bacterial in 84 (65.1%), viral in 66 (51.6%), and fungal in 24 (18.6%) recipients. Two-year OS was 58.1% [95% CI: 50.2–67.3]; NRM—27.1% [95% CI: 19.7–35]; PFS—50.4% [95% CI: 42.5–59.8]; and GRFS—38.8% [95% CI: 31.2–48.1]. About 50% of all deaths were directly caused by infection or infection-related conditions. Conclusions: Disease remission status at transplant significantly affected PFS, chronic GvHD, and GRFS. Although clinical applications of haplo-HCT with PTCy are widespread, the study confirms the need to reduce infection-related mortality after this type of GvHD prophylaxis. Keywords: hematological malignancies; haploidentical hematopoietic cell transplantation; post-transplant cyclophosphamide; graft-versus-host disease; non-infectious complications; infectious complications Author: Agnieszka Tomaszewska, Grzegorz W. Basak, Christophe Peczynski, Emmanuelle Polge, Pascale Ambron, William Boreland, Simona Sica, Mutlu Arat, Jakob Passweg, Jose Luis Lopez Lorenzo, Urpu Salmenniemi, Pavel Jindra, Alexander Kulagin, Rodrigo Martino Bufarull, Matthias Eder, Mohamed-Amine Bekadja, Alberto Mussetti, Charlotte E. Graham, Hélène Schoemans, Olaf Penack, Ivan Moiseev and Zinaida Perić Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Thu Dec 18 08:03:02 2025 CET ModDate: Thu Dec 18 09:03:39 2025 CET Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 17 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1767316 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- WYEKQU+VnURWPalladioL-Bold Type 1 Custom yes yes yes 105 0 QYPNST+URWPalladioL-Ital Type 1 Custom yes yes yes 106 0 ANJIQB+URWPalladioL-Bold Type 1 Custom yes yes yes 107 0 VRORMU+URWPalladioL-Roma Type 1 Custom yes yes yes 108 0 EILUJF+CMSY10 Type 1 Builtin yes yes yes 168 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 189 0 BHQDXW+Calibri TrueType WinAnsi yes yes yes 197 0 FSSGBO+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 198 0 IHEYRI+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 199 0 WPFZFG+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 200 0 BHQDXW+Calibri TrueType WinAnsi yes yes yes 224 0 FSSGBO+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 225 0 IHEYRI+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 226 0 WPFZFG+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 227 0 DPTUZS+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 228 0 FSSGBO+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 287 0 IHEYRI+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 288 0 WPFZFG+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 289 0 BHQDXW+Calibri TrueType WinAnsi yes yes yes 300 0 SRABBO+Calibri-Bold TrueType WinAnsi yes yes yes 301 0 FSSGBO+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 302 0 IHEYRI+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 303 0 WPFZFG+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 304 0 DPTUZS+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 305 0 FSSGBO+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 325 0 IHEYRI+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 326 0 WPFZFG+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 327 0 DPTUZS+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 328 0 FSSGBO+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 337 0 IHEYRI+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 338 0 WPFZFG+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 339 0 WULJEY+VnURWPalladioL Type 1 Custom yes yes yes 574 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-06-23 04:12:16 CEST RepresentationInformation: 329184.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-06-22 14:43:25 CEST Size: 1767316 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 620 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Children: Item: Title: Study Design and Inclusion Criteria Item: Title: Statistical Methods Item: Title: Results Children: Item: Title: Patients, Disease, and Transplant Characteristics Item: Title: Non-Infectious Complications Item: Title: GvHD Item: Title: Infectious Complications Item: Title: Transplantation Outcomes Item: Title: Discussion Item: Title: Conclusions Item: Title: References Info: Title: Complications of Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide—A Prospective Study on Behalf of the EBMT Transplant Complications Working Party Author: Agnieszka Tomaszewska, Grzegorz W. Basak, Christophe Peczynski, Emmanuelle Polge, Pascale Ambron, William Boreland, Simona Sica, Mutlu Arat, Jakob Passweg, Jose Luis Lopez Lorenzo, Urpu Salmenniemi, Pavel Jindra, Alexander Kulagin, Rodrigo Martino Bufarull, Matthias Eder, Mohamed-Amine Bekadja, Alberto Mussetti, Charlotte E. Graham, Hélène Schoemans, Olaf Penack, Ivan Moiseev and Zinaida Perić Subject: Background: Haploidentical hematopoietic cell transplantations (haplo-HCTs) with post-transplant cyclophosphamide (PT-Cy) are standard practice, but complications causing morbidity and mortality are not well described. Methods: The aim of this prospective non-interventional multicenter study was to document frequency of potential non-infectious and infection-related complications and main transplant outcomes after the first unmanipulated haplo-HCT with PT-Cy between 2017 and 2019 in 129 adult patients with hematological malignancies. The median follow-up was 37.3 months [95% CI: 34.3–39.7]. Results: The cumulative incidence (CI) of acute graft versus host disease (aGvHD) at day +100 was 22.4% grade II-IV [95% CI: 15.5–30.1] and 8.8% grade III-IV [95% CI: 4.6–14.6], respectively. The cumulative incidence of chronic GvHD (cGvHD) at 24 months was 25.8% [95% CI: 18.5–33.6]; extensive cGvHD was 10.9% [95% CI: 6.3–17.1], respectively. The most frequent non-infectious complications for the whole study population were mucositis—37.5% (n = 48); renal insufficiency—18% (n = 23); and cardiovascular complications—10.9% (n = 14). The following infection-related complications were diagnosed: bacterial in 84 (65.1%), viral in 66 (51.6%), and fungal in 24 (18.6%) recipients. Two-year OS was 58.1% [95% CI: 50.2–67.3]; NRM—27.1% [95% CI: 19.7–35]; PFS—50.4% [95% CI: 42.5–59.8]; and GRFS—38.8% [95% CI: 31.2–48.1]. About 50% of all deaths were directly caused by infection or infection-related conditions. Conclusions: Disease remission status at transplant significantly affected PFS, chronic GvHD, and GRFS. Although clinical applications of haplo-HCT with PTCy are widespread, the study confirms the need to reduce infection-related mortality after this type of GvHD prophylaxis. 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