03.23.21

Sitagliptin prevention of aGVHD

The following content was featured in a recent Abstracts newsletter distributed by ASTCT. The Abstracts newsletter highlights the latest research in the clinical research and translational science studies aspects of transplantation and cellular therapy. 

Farag SS, Zaid MA, Schwartz JE, et al. Dipeptidyl Peptidase 4 Inhibition for Prophylaxis of Acute Graft-Versus-Host Disease. New England Journal of Medicine. 2021; 384 (11): 19 (doi: 10.1056/NEJMoa2027372).

The likelihood of acute graft-versus-host disease (GVHD) after allogeneic stem-cell transplantation may be reduced by inhibiting dipeptidyl peptidase 4 (DPP-4, also known as CD26), a receptor involved in T cell activation. A Phase II study backed by the National Heart, Lung, and Blood Institute explored the use of triple therapy with sitagliptin, tacrolimus, and sirolimus in this context. The study included 36 participants undergoing peripheral-blood stem-cell transplants from matched donors. Each received oral sitagliptin on a 12-hour cycle starting the day before the procedure and continuing for 14 days post-transplantation. Acute GVHD presented in two patients by the 100-day mark. The incidence of grade II to IV GVHD declined from 30% to 5% over that time frame, beating the target outcome of no more than 15% prevalence. The cumulative incidences of relapse and chronic GVHD were 26% and 37%, respectively, at 1 year. The research also found nonrelapse mortality at zero and GVHD-free, relapse-free survival of 46% at 1 year post HCT.

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