{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T17:22:31Z","timestamp":1773681751870,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Oral budesonide exerts local effects with negligible systemic glucocorticoid activity, due to rapid first\u2010pass metabolism, therefore, could potentially be efficacious in preventing gastrointestinal (GI) acute GVHD (aGVHD). We explored the use of budesonide, added to posttransplant cyclophosphamide (PTCy), tacrolimus, and mycophenolate mofetil, for prevention of GI aGVHD after allogeneic hematopoietic stem cell transplantation (AHSCT) in a prospective observational study and treated 80 patients with a median age of 53\u2009years (range 19\u201374). Results were compared with a publicly available CIBMTR dataset of 646 patients who received PTCy\u2010based GVHD prophylaxis (CIBMTR Study # GV17\u201002) (control). Cumulative incidence (CI) of 3\u2010month grade 2\u20134 and grade 3\u20134 aGVHD in the budesonide and control groups were 3.8% vs. 34.4% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and 1.3% vs. 9.8% (<jats:italic>p<\/jats:italic>\u2009=\u20090.029), respectively. One\u2010year GRFS (70.5% vs. 31.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), PFS (73.4% vs. 52.8%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003), and OS (80.1% vs. 64.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.038) were significantly higher in the budesonide group compared with control group. Propensity score\u2010adjusted analyses showed that the addition of budesonide significantly decreased risk of aGVHD grade 2\u20134 (HR 0.29, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), grade 3\u20134 (HR 0.12, <jats:italic>p<\/jats:italic>\u2009=\u20090.045), and cGVHD (HR 0.22, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), which resulted in better GRFS (HR 0.38, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), PFS (HR 0.58, <jats:italic>p<\/jats:italic>\u2009=\u20090.012), and OS (HR 0.72, <jats:italic>p<\/jats:italic>\u2009=\u20090.044). Similar results were found when using propensity score\u2010matched analysis restricted to recipients of haploidentical transplantation. In conclusion, addition of budesonide to PTCy\u2010based GVHD prophylaxis is safe and effective in preventing severe acute GI GVHD with significantly improved GRFS. These results could facilitate transition to peripheral blood grafts for all allogeneic transplant recipients.<\/jats:p>","DOI":"10.1002\/ajh.27581","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T06:10:05Z","timestamp":1736316605000},"page":"383-392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Budesonide, Added to <scp>PTCy<\/scp>\u2010Based Regimen, for Prevention of Acute <scp>GI GVHD<\/scp> After Allogeneic Stem Cell Transplantation"],"prefix":"10.1002","volume":"100","author":[{"given":"Piyanuch","family":"Kongtim","sequence":"first","affiliation":[{"name":"Hematopoietic Stem Cell Transplant and Cellular Therapy Program, Division of Hematology\/Oncology, Department of Medicine, Chao Family Comprehensive Cancer Center University of California Irvine  Irvine California 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Cellular Therapy Program, Division of Hematology\/Oncology, Department of Medicine, Chao Family Comprehensive Cancer Center University of California Irvine  Irvine California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1678-1345","authenticated-orcid":false,"given":"Benjamin J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of California Irvine  Orange California USA"},{"name":"Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences University of California Irvine  Irvine California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Doh","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of California Irvine  Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn P.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of 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