{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T15:23:19Z","timestamp":1777648999990,"version":"3.51.4"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Bone Marrow Transplant"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We retrospectively analyzed data from the EBMT registry on patients with pretransplant comorbidities associated with cardiovascular risk. Patients who underwent first allogeneic hematopoietic cell transplantation for acute myeloid leukemia in first complete remission between 2010 and 2022 from unrelated donors using post-transplant cyclophosphamide (ptCy) or anti-thymocyte globulin (ATG)-based graft-versus-host disease prophylaxis with a history of cardiac disease, arrhythmia, diabetes, obesity or cerebrovascular disease according to the HCT-specific comorbidity index were included. We performed a matched-pair analysis using a propensity score. After matching, 432 patients were included: 313 in the ATG group and 119 in the ptCy group. At 2 years, overall survival was 67.5% (95% CI 61\u201373.2) and 68.6% (95% CI 56.7\u201377.8); leukemia-free survival was 60.4% (95% CI 53.8\u201366.4) and 62.6% (95% CI 50.4\u201372.6); relapse incidence was 22.1% (95% CI 17\u201327.7) and 23.2% (95% CI 14.3\u201333.4); non-relapse mortality was 17.5% (95% CI 13.1\u201322.4) and 14.1% (95% CI 7.5\u201322.8), respectively. In conclusion, our study suggests that the use of ptCY for GVHD prophylaxis in patients with preexisting comorbidities associated with cardiovascular risk yields long-term outcomes comparable to those observed with ATG-based approaches.<\/jats:p>","DOI":"10.1038\/s41409-025-02766-0","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T15:48:44Z","timestamp":1764776924000},"page":"206-210","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Posttransplant cyclophosphamide versus antithymocyte globulin in patients with cardiovascular comorbidity undergoing allogeneic hematopoietic cell transplantation for acute myeloid leukaemia in first complete remission from unrelated donors: a retrospective matched-pair analysis from the ALWP of the EBMT"],"prefix":"10.1038","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4274-3895","authenticated-orcid":false,"given":"Jan","family":"Vydra","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allain-Thibeault","family":"Ferhat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5103-9966","authenticated-orcid":false,"given":"Nicolaus","family":"Kr\u00f6ger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Gedde-Dahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Eder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Schroeder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Urpu","family":"Salmenniemi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00e9gis Peffault","family":"de Latour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7092-3351","authenticated-orcid":false,"given":"Jakob","family":"Passweg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4524-8782","authenticated-orcid":false,"given":"Ibrahim","family":"Yakoub-Agha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3739-7502","authenticated-orcid":false,"given":"Alessandro","family":"Rambaldi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6565-3393","authenticated-orcid":false,"given":"Robert","family":"Zeiser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9331-5145","authenticated-orcid":false,"given":"Matthias","family":"Stelljes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Carlson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Castilla-Llorente","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3097-2532","authenticated-orcid":false,"given":"Alexandros","family":"Spyridonidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3304-9965","authenticated-orcid":false,"given":"Bipin","family":"Savani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Ciceri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7264-808X","authenticated-orcid":false,"given":"Mohamad","family":"Mohty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"2766_CR1","doi-asserted-by":"crossref","unstructured":"Brissot E, Labopin M, Labussi\u00e8re H, Fossard G, Chevallier P, Guillaume T, et al. Post-transplant cyclophosphamide versus anti-thymocyte globulin after reduced intensity peripheral blood allogeneic cell transplantation in recipients of matched sibling or 10\/10 HLA matched unrelated donors: final analysis of a randomized, open-label, multicenter, phase 2 trial. Blood Cancer J. 2024;14:31.","DOI":"10.1038\/s41408-024-00990-3"},{"key":"2766_CR2","doi-asserted-by":"crossref","unstructured":"Ruggeri A, Labopin M, Bacigalupo A, Afanasyev B, Cornelissen JJ, Elmaagacli A, et al. Post-transplant cyclophosphamide for graft-versus-host disease prophylaxis in HLA matched sibling or matched unrelated donor transplant for patients with acute leukemia, on behalf of ALWP-EBMT. J Hematol Oncol. 2018;11:40.","DOI":"10.1186\/s13045-018-0586-4"},{"key":"2766_CR3","doi-asserted-by":"crossref","unstructured":"Passweg JR, Baldomero H, Atlija M, Kleovoulou I, Witaszek A, Alexander T, et al. The 2023 EBMT report on hematopoietic cell transplantation and cellular therapies. Increased use of allogeneic HCT for myeloid malignancies and of CAR-T at the expense of autologous HCT. Bone Marrow Transpl. 2025;60:519\u201328.","DOI":"10.1038\/s41409-025-02524-2"},{"key":"2766_CR4","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.jaccao.2021.02.011","volume":"3","author":"R Dul\u00e9ry","year":"2021","unstructured":"Dul\u00e9ry R, Mohty R, Labopin M, Sestili S, Malard F, Brissot E, et al. Early cardiac toxicity associated with post-transplant cyclophosphamide in allogeneic stem cell transplantation. JACC CardioOncol. 2021;3:250\u20139. https:\/\/pubmed.ncbi.nlm.nih.gov\/34396331\/.","journal-title":"JACC CardioOncol"},{"key":"2766_CR5","doi-asserted-by":"publisher","first-page":"2018","DOI":"10.1182\/bloodadvances.2022008792","volume":"7","author":"AI P\u00e9rez-Valencia","year":"2023","unstructured":"P\u00e9rez-Valencia AI, Cascos E, Carbonell-Ordeig S, Charry P, G\u00f3mez-Hernando M, Rodr\u00edguez-Lobato LG, et al. Incidence, risk factors, and impact of early cardiac toxicity after allogeneic hematopoietic cell transplant. Blood Adv. 2023;7:2018\u201331.","journal-title":"Blood Adv"},{"key":"2766_CR6","doi-asserted-by":"publisher","first-page":"1694","DOI":"10.1038\/s41409-024-02414-z","volume":"59","author":"MQ Salas","year":"2024","unstructured":"Salas MQ, Cascos E, L\u00f3pez-Garc\u00eda A, P\u00e9rez-L\u00f3pez E, Baile-Gonz\u00e1lez M, L\u00f3pez-Corral L, et al. Cardiac events occurring after allogeneic hematopoietic cell transplantation with post-transplant cyclophosphamide. Study conducted on behalf of the GETH-TC. Bone Marrow Transpl [Internet]. 2024;59:1694\u2013703. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/39277653.","journal-title":"Bone Marrow Transpl [Internet]"},{"key":"2766_CR7","doi-asserted-by":"publisher","first-page":"208.e1","DOI":"10.1016\/j.jtct.2023.10.011","volume":"30","author":"FI LeMaistre","year":"2024","unstructured":"LeMaistre FI, Tsai HL, Varadhan R, Al-Talib T, Jones R, Ambinder A. Allogeneic hematopoietic cell transplantation with non-myeloablative conditioning and post-transplant cyclophosphamide prophylaxis in patients with reduced systolic function. Transplant Cell Ther [Internet]. 2024;30:208.e1\u2013208.e7. https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2666636723016135.","journal-title":"Transplant Cell Ther [Internet]"},{"key":"2766_CR8","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.lfs.2018.12.018","volume":"218","author":"A Iqubal","year":"2019","unstructured":"Iqubal A, Iqubal MK, Sharma S, Ansari MA, Najmi AK, Ali SM, et al. Molecular mechanism involved in cyclophosphamide-induced cardiotoxicity: old drug with a new vision. Life Sci. 2019;218:112\u201331. https:\/\/pubmed.ncbi.nlm.nih.gov\/30552952\/.","journal-title":"Life Sci"},{"key":"2766_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.46989\/001c.94952","volume":"6","author":"J Sawyer","year":"2024","unstructured":"Sawyer J, Elliott T, Orton L, Sowell H, Gatwood K, Shultes K. Prevention and management of acute toxicities from conditioning regimens during hematopoietic stem cell transplantation. Clin Hematol Int. 2024;6:1\u201310.","journal-title":"Clin Hematol Int"},{"key":"2766_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.46989\/001c.124926","volume":"6","author":"R Shah","year":"2024","unstructured":"Shah R, Murphy D, Logue M, Jerkins J, Jallouk A, Adetola K, et al. Multidisciplinary management of morbidities associated with chronic graft-versus-host disease. Clin Hematol Int. 2024;6:1\u201315.","journal-title":"Clin Hematol Int"}],"container-title":["Bone Marrow Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41409-025-02766-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41409-025-02766-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41409-025-02766-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T22:02:33Z","timestamp":1771279353000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41409-025-02766-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,3]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["2766"],"URL":"https:\/\/doi.org\/10.1038\/s41409-025-02766-0","relation":{},"ISSN":["0268-3369","1476-5365"],"issn-type":[{"value":"0268-3369","type":"print"},{"value":"1476-5365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,3]]},"assertion":[{"value":"7 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 December 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This manuscript follows the relevant guidelines and regulations as appropriate. The study is based on data reported to the EBMT registry. EBMT centers commit to obtain informed consent according to the local regulations applicable at the time of transplantation in order to report pseudonymized data to the EBMT. All EBMT registry studies are performed under the supervision of the EBMT Working Parties. This study was approved by the Acute Leukemia Working Party (ALWP) of the EBMT.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}