Photo Credit: Vadym Terelyuk
The following is a summary of “Rapid tapering of cyclosporine after allogeneic transplantation for high-risk hematological malignancies,” published in the February 2025 issue of International Journal of Hematology by Gomyo et al.
Early cyclosporine (CsA) taper after allogeneic transplantation may enhance the graft-versus-leukemia/lymphoma (GVL) effect, but its impact on outcomes remains unclear.
Researchers conducted a retrospective study of patients with hematological outcomes in high-risk malignancies based on CsA tapering timing.
They maintained blood CsA at 300 ng/ml and tapered it by 10% per week from day 30 for related HSCT or day 50 for unrelated HSCT in patients without or with limited graft-versus-host disease (GVHD). They tapered CsA in 36 patients, classifying them as “On-schedule” or “Delayed” based on tapering start time.
The results showed grade II-IV acute GVHD in 33.8% and 39.4% (P = 0.746) of the On-schedule and Delayed groups. The On-schedule group had higher relapse rates, worse overall survival (55.6% vs 72.2% at 1y, P = 0.025), and worse disease-free survival (DFS) (38.9% vs 66.7% at 1y, P = 0.059) with no difference in non-relapse mortality.
Investigators found that early CsA tapering after HSCT in high-risk patients was not effective.
Source: link.springer.com/article/10.1007/s12185-024-03913-x
