Post-transplant PTCy and abatacept for GVHD prophylaxis
Koura D, Dykes KC, Goodman AM, et al. A Prospective Clinical Trial of GVHD Prophylaxis with Post-Transplant Cyclophosphamide and Abatacept. Blood Advances. 2025; (doi: 10.1182/bloodadvances.2024015094).
Researchers report favorably on the use of combined post-transplant cyclophosphamide (PTCy) and abatacept as prevention against graft-versus-host disease (GVHD) after allogeneic transplantation for hematologic malignancies. In a prospectively randomized trial, 25 patients were rallocated to PTCy on days +3 and +4, followed by abatacept on days +5, +14, +28 and then every 4 weeks up to D+168. The control cohort included 15 patients randomly selected for standard GVHD prophylaxis with methotrexate and tacrolimus . At 1 year, GVHD-free, relapse-free survival was measured at 62.5% in the PTCy+abatacept group vs. 24.1% among the controls. Compared with standard prophylaxis, the novel regimen was associated with lower rates of both moderate-to-severe chronic GVHD and grade III/IV acute GVHD: 0% vs. 65.6% and 4.2% vs. 21.4%, respectively. The findings also demonstrate that GVHD prophylaxis does not rely on the use of a calcineurin inhibitor, such as tacrolimus.