{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:56:29Z","timestamp":1788260189274,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Sirolimus has emerged as an alternative to calcineurin inhibitors\u2010based (CNI) graft\u2010versus\u2010host disease (GVHD) prophylaxis. This retrospective study compares the outcome of 133 consecutive adult patients with haematological malignancies undergoing haploidentical stem cell transplantation with posttransplant cyclophosphamide (PTCy) and mycophenolate mofetil (MMF), combined with cyclosporine A (PTCy\u2013CsA\u2013MMF, <jats:italic>n<\/jats:italic>\u00a0=\u00a067) or sirolimus (PTCy\u2013Sir\u2013MMF, <jats:italic>n<\/jats:italic>\u00a0=\u00a066) as GVHD prophylaxis strategy. The median follow\u2010up was 48 (range 22\u201383) and 13 (range 3\u201333) months, respectively. PTCy\u2013CsA\u2013MMF was associated in multivariate analyses with a higher risk of acute kidney injury (HR 2.1, 95% CI, 1.21\u20133.57, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.008) and thrombotic microangiopathy (HR 12.5, 95% CI, 1.66\u201393.5, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.014), whereas PTCy\u2013Sir\u2013MMF was associated with a higher risk of hepatic sinusoidal obstruction syndrome (SOS) (HR 10.8, 95% CI, 1.52\u201377, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.018), especially late\u2010onset forms, which totally resolved and none of the patients needed discontinuation of sirolimus. Two SOS\u2010related deaths were detected, both in the PTCy\u2013CsA\u2013MMF subgroup. Both GVHD prophylaxis strategies were otherwise comparable in terms of engraftment, GVHD incidence and survival.<\/jats:p>","DOI":"10.1002\/jha2.183","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T10:45:06Z","timestamp":1616064306000},"page":"236-248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Sirolimus versus cyclosporine in haploidentical stem cell transplantation with posttransplant cyclophosphamide and mycophenolate mofetil as graft\u2010versus\u2010host disease prophylaxis"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1043-8076","authenticated-orcid":false,"given":"Rafael","family":"Hernani","sequence":"first","affiliation":[{"name":"Department of Haematology Hospital Cl\u00ednico Universitario Institute for Research INCLIVA  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 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