{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:18:12Z","timestamp":1783012692987,"version":"3.54.6"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Regimens combining calcineurin inhibitors with methotrexate or mycophenolate have been the backbone for graft\u2010versus\u2010host disease (GVHD) prophylaxis. Early studies highlighted a delicate dose\u2013response balance. The inclusion criteria comprised randomized clinical trials of patients with hematologic malignancies undergoing sibling\u2010 or unrelated\u2010donor transplants, adding a pharmacologic immunosuppressive agent to standard GVHD prophylaxis. This meta\u2010analysis examined the impact of intensified GVHD prophylaxis strategies on relapse risk and included 16 randomized controlled trials among 26 eligible studies, with 1344 patients in the intervention group and 1260 in the control group. Few mismatched donors or children were included. The studies evaluated additions such as anti\u2010thymocyte\/lymphocyte globulin (ATG, ATLG), posttransplant cyclophosphamide (PTCy), sirolimus, abatacept, and alemtuzumab. Results showed no significant effect on relapse risk or progression\u2010free survival overall, with HR\u2009=\u20091.12 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.16) for relapse and HR\u2009=\u20090.92 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.16) for progression\u2010free survival. Sensitivity analysis identified one outlier study using alemtuzumab that reported higher relapse and indicated a modest increased risk with ATLG. The findings suggest that adding agents like ATG, sirolimus, abatacept, or PTCy does not increase relapse risk in matched sibling or unrelated transplants. While caution is advised with ATLG and alemtuzumab, the overall evidence supports the safety of modern prophylactic strategies, potentially improving transplant outcomes without compromising relapse risk.\n                  <\/jats:p>","DOI":"10.1111\/ejh.70188","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T03:04:31Z","timestamp":1776913471000},"page":"432-441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Modern Strategies for Graft\u2010Versus\u2010Host Disease Prophylaxis on Relapse Risk in Matched\u2010Sibling or Unrelated Donor Hematopoietic Cell Transplantation: A Systematic Review and Meta\u2010Analysis of Randomized Trials"],"prefix":"10.1111","volume":"117","author":[{"given":"Leonardo Javier","family":"Arcuri","sequence":"first","affiliation":[{"name":"Hospital Israelita Albert Einstein Academic Research Organization  Sao Paulo Brazil"},{"name":"Instituto Nacional de Cancer Bone Marrow Transplant Unit  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Hugo Glasser","family":"Natal","sequence":"additional","affiliation":[{"name":"Hospital Pro Cardiaco Hematology Department  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 Dias","family":"Am\u00e9rico","sequence":"additional","affiliation":[{"name":"Beneficencia Portuguesa de S\u00e3o Paulo Bone Marrow Transplant Unit  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme","family":"Perini","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein Bone Marrow Transplant Unit  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Nassif","family":"Kerbauy","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein Bone Marrow Transplant Unit  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucila Nassif","family":"Kerbauy","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein Bone Marrow Transplant Unit  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Cardoso Martins","family":"Lima","sequence":"additional","affiliation":[{"name":"Universidade Federal Do Parana Histocompatibility Lab  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s G\u00f3mez","family":"De Le\u00f3n","sequence":"additional","affiliation":[{"name":"Hematology Department Universidad Autonoma de Nuevo Leon  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreza Alice Feitosa","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein Bone Marrow Transplant Unit  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Pires","family":"de Souza Santos","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein Bone Marrow Transplant Unit  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Panzarella","sequence":"additional","affiliation":[{"name":"Division of Biostatistics University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irwin","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Medicine McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Hamerschlak","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein Bone Marrow Transplant Unit  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanderson","family":"Rocha","sequence":"additional","affiliation":[{"name":"Hematology and Cell Therapy Department Universidade de Sao Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"de Oliveira Ribeiro","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cancer Bone Marrow Transplant Unit  Rio de Janeiro Brazil"},{"name":"Complexo Hospitalar de Niteroi Bone Marrow Transplant Unit  Niteroi Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"issue":"2","key":"e_1_2_11_2_1","first-page":"S50","article-title":"Cyclosporine\u2010A as GVHD Prophylaxis in Allogeneic BMT for Childhood Acute Leukemia. 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