A recent retrospective multicenter analysis study, published in the journal Bone MarrowTransplantation, found that graft-versus-host disease (GVHD) was not associated with lower relapse after haploidentical stem-cell transplantation (haploSCT) with post-transplant cyclophosphamide (PTCy) treatment. While an association between GVHD and graft-versus-leukemia (GvL) effects exists, their findings suggest that PTCy allows the separation of GvL from GVHD in haploSCT settings.
For hematological malignancies such as acute myeloid leukemia (AML), allogeneic SCT is widely used as a curative treatment. As SCT can lead to GVHD, researchers have found that mild forms of acute or chronic GVHD are associated with better survival and lower risk of relapse due to GvL effects. While the use of PTCy is common for prophylaxis against GVHD, there is limited data on the association between GVHD and GvL in this context. Therefore, the authors sought to explore the relationship between GVHD and GvL in AML patients who underwent with haploSCT with PTCy.
This study analyzed 805 AML patients following haploSCT with PTCy. The authors found that neither acute or chronic GVHD of any grade protected from relapse. More severe GVHD forms were found to increase non-relapse mortality (NRM) and reduce survival. These findings suggest that GVHD of any type does not improve survival or relapse rate in AML patients after haploSCT and PTCy treatment.
Shimoni A, Labopin M, Angelucci E, et al. The association of graft-versus-leukemiaeffect and graft-versus host disease in haploidentical transplantation with post-transplant cyclophosphamide for AML [published online ahead of print, 2022 Jan13].Bone Marrow Transplant. 2022;10.1038/s41409-021-01493-6.