{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:46:52Z","timestamp":1787021212916,"version":"build-2736575974"},"reference-count":41,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Post-transplant cyclophosphamide (PTCy) is increasingly used for graft-versus-host disease (GVHD) prophylaxis, but long-term outcomes remain incompletely defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS AND METHODS<\/jats:title>\n                    <jats:p>We analyzed 874 relapse-free survivors at 2 years from 2,046 patients who underwent allogeneic hematopoietic stem-cell transplantation (HSCT) for hematologic malignancies between 2010 and 2022. GVHD prophylaxis included PTCy plus rabbit antithymocyte globulin (ATG) and a calcineurin inhibitor (CnI; Group I, n = 429) or alternative regimens (Group II, n = 445).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      With an overall follow-up of 5,275 person-years after HSCT, overall survival (OS) 3 years after the landmark was 88.7% (95% CI, 86 to 91). Patients receiving ATG-PTCy-CnI had improved outcomes compared with those receiving alternative regimens, with OS of 93.2% versus 85.0% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), and lower nonrelapse mortality (NRM; 3.4%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      10.8%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). On multivariable analysis, ATG-PTCy-CnI was independently associated with improved OS (hazard ratio [HR], 0.41; 95% CI, 0.21 to 0.79;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007) and lower NRM (HR, 0.34; 95% CI, 0.17 to 0.74;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .006). Chronic GVHD remained the leading cause of late mortality; deaths from GVHD, infections, treatment-related toxicity, and second primary malignancies were all reduced with ATG-PTCy-CnI. The cumulative incidence of relapse was similar between groups. Standardized mortality ratios were 1.32 for ATG-PTCy-CnI and 2.06 for other regimens, corresponding to a 1.6-fold higher excess mortality with alternative prophylaxis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .036).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Among patients alive and relapse-free at least 2 years after HSCT, long-term outcomes were excellent. The use of ATG-PTCy-CnI prophylaxis was associated with further improvements in survival through reductions in GVHD-related mortality and late complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-25-01308","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T19:59:21Z","timestamp":1782763161000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Graft-Versus-Host Disease Prophylaxis on Long-Term Outcomes in Patients Surviving Beyond Two Years After Allogeneic Transplantation"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1055-3245","authenticated-orcid":true,"given":"Nihar","family":"Desai","sequence":"first","affiliation":[{"name":"Hans Messner Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada"},{"name":"Temerty Department of 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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7595-0113","authenticated-orcid":true,"given":"Fotios V.","family":"Michelis","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada"},{"name":"Temerty Department of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9690-4669","authenticated-orcid":true,"given":"Auro","family":"Viswabandya","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada"},{"name":"Temerty Department of Medicine, University of Toronto, Toronto, ON, 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