08.17.21

Posttransplant cyclophosphamide as GVHD prophylaxis for peripheral blood stem cell HLA-mismatched unrelated donor transplant

New research published in the journal Blood explores the use of posttransplant cyclophosphamide (PTCy) therapy for patients receiving a mismatched unrelated donor (MMUD) allogeneic hematopoietic cell transplantation (HCT). Outcomes of the PTCy treatment proved effective, with a Graft Versus Host Disease (GVHD) free and Relapse Free Survival (GRFS) rate of 68% and an Overall Survival (OS) rate of 87%.

For patients receiving HCT, there is a risk of developing GVHD, with higher rates of GVHD observed among patients who receive an MMUD transplant. In this study, researchers performed a 2-strata pilot clinical trial to observe the efficacy of PTCy therapy in MMUD-HCT patients, whereby patients were administered either a myeloablative or reduced intensity conditioning regimen. 38 patients were included in this study, with 61% identified as racial or ethnic minorities.

The promising OS and GRFS rates exhibited for PTCy therapy are encouraging, as fully matched unrelated donors or HLA-identical siblings are not always available, particularly for Hispanic or Black patients of South or Central American descent. Moreover, this study's GRFS rate is based on a 1-year follow-up period, and thus bridges a gap in other studies of GVHD therapies which include shorter periods of patient follow-up.

Reference:

Al Malki MM, Tsai NC, Palmer J, et al. Posttransplant cyclophosphamide as GVHD prophylaxis for peripheral blood stem cell HLA-mismatched unrelated donor transplant. Blood Adv. 2021;5(12):2650-2659. https://doi.org/10.1182/bloodadvances.2021004192

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