03.16.22

Abatacept Treatment Can Reduce the Impact of Mismatching in Unrelated Donor Stem Cell Transplantation

 

In a study published in the journal Blood, researchers have found that adding abatacept to calcineurin inhibitor and short-course methotrexate (CNI/MTX) treatment reduced the risk of acute graft-versus-host disease (aGVHD) and non-relapse mortality (NRM) for mismatched donor recipients.

Allogeneic hematopoietic cell transplantation (HCT) is an approved treatment for certain hematologic malignancies. In the United States, there is limited availability of 8/8 HLA-matched unrelated donors (MUD) for persons of color, although 7/8 matched unrelated donors (MMUD) are more available. Unfortunately, mismatched donors increase the risk of aGVHD and reduce overall survival (OS). Abatacept, acostimulation blockade agent, has been shown to reduce severe aGVHD. Therefore, the authors sought to determine if abatacept could reduce the risks associated with mismatching.

The authors performed a post-hoc analysis on the phase 2 trial Abatacept 2 (ABA2,NCT01743131) data comparing patients with MMUD receiving CNI/MTX and abatacept to patients with MUD receiving CNI/MTX alone. The authors found that CNI/MTX with abatacept greatly reduced the risks of severe aGVHD and NRM without increasing the risk of relapse. These findings also highlight the use of abatacept to reduce racial disparities due to the limited availability of HLA-matched unrelated donors for POC.

 

Reference:

Qayed M, Watkins B, Gillespie S, et al. Abatacept for GVHD prophylaxis can reduce racial disparities by abrogating the impact of mismatching in unrelated donor stem cell transplantation. Blood Adv. 2022;6(3):746-749.

https://doi.org/10.1182/bloodadvances.2021005208

 

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