Impact of post-transplant cyclophosphamide and splenomegaly on primary graft failure and multi-lineage cytopenia after allogeneic hematopoietic cell transplantation

Emma Zulch; Yoshitaka Inoue; Joseph Cioccio; Kevin Rakszawski; Natthapol Songdej; Myles Nickolich; Hong Zheng; Seema Naik; Witold Rybka; Christopher Ehmann; Jeffrey Sivik; Jseph Mierski; Brooke Silar; Caitlin Vajdic; Robert Greiner; Valerie Brown; Raymond Hohl; David Claxton; Hiroko Shike; Catharine I. Paules; Shin Mineishi; Kentaro Minagawa

Impact of post-transplant cyclophosphamide and splenomegaly on primary graft failure and multi-lineage cytopenia after allogeneic hematopoietic cell transplantation

Primary graft failure (PGF) and multi-lineage cytopenia (MLC) increase the risk of nonrelapse mortality in allogeneic hematopoietic cell transplants (HCT). We evaluated the impact of post-transplant cyclophosphamide (PTCy) and splenomegaly on PGF and MLC for hematological malignancies. This study included patients with PTCy (N=84) and conventional graft-vs.-host disease prophylaxis (N=199). The occurrence of splenomegaly varied widely, ranging from 17.1 % (acute myeloid leukemia) to 66.7 % (myeloproliferative neoplasms). Ten patients (N=8 in the PTCy and N=2 in the non- PTCy) developed PGF, and 44 patients developed MLC (both N=22). PTCy and severe splenomegaly (≥20 cm) were risk factors for PGF (odds ratio (OR): 10.40, p<0.01 and 6.74, p=0.01 respectively). Moreover, severe splenomegaly was a risk factor for PGF in PTCy patients (OR: 10.20, p=0.01). PTCy (hazard ratio (HR) 2.09, p=0.02), moderate (≥15, <20 cm, HR 4.36, p<0.01), and severe splenomegaly (HR 3.04, p=0.01) were independent risk factors for MLC. However, in subgroup analysis in PTCy patients, only mild splenomegaly (≥12, <15 cm, HR 4.62, p=0.01) was a risk factor for MLC. We recommend all patients be screened for splenomegaly before HCT, and PTCy is cautioned in those with splenomegaly.

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Metadata

Work Title	Impact of post-transplant cyclophosphamide and splenomegaly on primary graft failure and multi-lineage cytopenia after allogeneic hematopoietic cell transplantation
Access	Open Access
Creators	Emma Zulch Yoshitaka Inoue Joseph Cioccio Kevin Rakszawski Natthapol Songdej Myles Nickolich Hong Zheng Seema Naik Witold Rybka Christopher Ehmann Jeffrey Sivik Jseph Mierski Brooke Silar Caitlin Vajdic Robert Greiner Valerie Brown Raymond Hohl David Claxton Hiroko Shike Catharine I. Paules Shin Mineishi Kentaro Minagawa
Keyword	Primary engraftment failure Poor graft function PTCy Splenomegaly Spleen size
License	In Copyright (Rights Reserved)
Work Type	Article
Publisher	Leukemia Research
Publication Date	June 8, 2024
Publisher Identifier (DOI)	https://doi.org/10.1016/j.leukres.2024.107530
Deposited	May 19, 2025

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Version 1
published

Created

May 19, 2025 17:26 by Researcher Metadata Database
Added Zulch-Leuk_Res-2024.pdf

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator E Zulch

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Y Inoue

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator J Cioccio

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Kevin Rakszawski

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Natthapol Songdej

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Myles Nickolich

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Hong Zheng

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Seema Naik

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Witold Rybka

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Christopher Ehmann

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator J Sivik

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator J Mierski

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator B Silar

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator C Vajdic

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Robert Greiner

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Valerie Brown

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Raymond Hohl

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator David Claxton

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Hiroko Shike

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Catharine I. Paules

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Shin Mineishi

May 19, 2025 17:26 by Researcher Metadata Database
Added Creator Kentaro Minagawa

May 19, 2025 17:26 by Researcher Metadata Database
Published

May 19, 2025 17:26 by Researcher Metadata Database
Updated

May 23, 2025 22:05 by [unknown user]
Updated Keyword, Publication Date Show Changes

July 16, 2025 14:52 by avs5190
Keyword
- Primary engraftment failure, Poor graft function, PTCy, Splenomegaly, Spleen size
Publication Date
- ~~2024-08-01~~
- 2024-06-08
Renamed Creator Emma Zulch Show Changes

July 16, 2025 14:54 by avs5190
- ~~E Zulch~~
- Emma Zulch
Renamed Creator Yoshitaka Inoue Show Changes

July 16, 2025 14:54 by avs5190
- ~~Y Inoue~~
- Yoshitaka Inoue
Renamed Creator Joseph Cioccio Show Changes

July 16, 2025 14:54 by avs5190
- ~~J Cioccio~~
- Joseph Cioccio
Renamed Creator Jeffrey Sivik Show Changes

July 16, 2025 14:54 by avs5190
- ~~J Sivik~~
- Jeffrey Sivik
Renamed Creator Jseph Mierski Show Changes

July 16, 2025 14:54 by avs5190
- ~~J Mierski~~
- Jseph Mierski
Renamed Creator Brooke Silar Show Changes

July 16, 2025 14:54 by avs5190
- ~~B Silar~~
- Brooke Silar
Renamed Creator Caitlin Vajdic Show Changes

July 16, 2025 14:54 by avs5190
- ~~C Vajdic~~
- Caitlin Vajdic

Version 2
published

Created

October 24, 2025 12:03 by avs5190
Deleted Zulch-Leuk_Res-2024.pdf

October 24, 2025 12:03 by avs5190
Added AccessibleCopy_7-16_Impact_of_post-transplant_cyclophosphamide-tagged.pdf

October 24, 2025 12:03 by avs5190
Published

October 24, 2025 12:03 by avs5190

Impact of post-transplant cyclophosphamide and splenomegaly on primary graft failure and multi-lineage cytopenia after allogeneic hematopoietic cell transplantation

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View: AccessibleCopy_7-16_Impact_of_post-transplant_cyclophosphamide-tagged.pdf

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Version 1
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