Oncology

Chronic Graft-versus-Host Disease

Expert Roundtables Podcast: Advances in Graft-versus-Host Disease Prophylaxis and Prevention

expert roundtables by Corey Cutler, MD, MPH, FRCPC; Zachariah DeFilipp, MD; Miguel-Angel Perales, MD

Overview

Recent advances in the prophylaxis and prevention of graft-versus-host disease (GVHD) have centered around optimizing posttransplant cyclophosphamide (PTCy) therapy and improving graft manipulation techniques. Our expert panel discusses the use of PTCy and novel strategies that aim to further minimize one’s risk of developing GVHD.

References

Anasetti C, Logan BR, Lee SJ, et al; Blood and Marrow Transplant Clinical Trials Network. Peripheral-blood stem cells versus bone marrow from unrelated donors. N Engl J Med. 2012;367(16):1487-1496. doi:10.1056/NEJMoa1203517

Bolaños-Meade J, Hamadani M, Wu J, et al; BMT CTN 1703 Investigators. Post-transplantation cyclophosphamide-based graft-versus-host disease prophylaxis. N Engl J Med. 2023;388(25):2338-2348. doi:10.1056/NEJMoa2215943

Herzog S, Shanley R, Holtan SG, MacMillan ML, Weisdorf DJ, El Jurdi N. Treatment-responsive acute graft-versus-host disease after post-transplantation cyclophosphamide-based prophylaxis: incidence and clinical outcomes. Transplant Cell Ther. 2024;30(7):688.e1-688.e9. doi:10.1016/j.jtct.2024.05.007

Lee SJ, Logan B, Westervelt P, Cutler C, et al. Comparison of patient-reported outcomes in 5-year survivors who received bone marrow vs peripheral blood unrelated donor transplantation: long-term follow-up of a randomized clinical trial. JAMA Oncol. 2016;2(12):1583-1589. doi:10.1001/jamaoncol.2016.2520

Luznik L, Pasquini MC, Logan B, et al. Randomized phase III BMT CTN trial of calcineurin inhibitor-free chronic graft-versus-host disease interventions in myeloablative hematopoietic cell transplantation for hematologic malignancies. J Clin Oncol. 2022;40(4):356-368. doi:10.1200/JCO.21.02293

Maurer K, Ho VT, Inyang E, et al. Posttransplant cyclophosphamide vs tacrolimus-based GVHD prophylaxis: lower incidence of relapse and chronic GVHD. Blood Adv. 2023;7(15):3903-3915. doi:10.1182/bloodadvances.2023009791

Shaffer BC, Gooptu M, DeFor TE, et al. Post-transplant cyclophosphamide–based graft-versus-host disease prophylaxis attenuates disparity in outcomes between use of matched or mismatched unrelated donors. J Clin Oncol. 2024;42(28):3277-3286. doi:10.1200/JCO.24.00184