GVHD
Published on May 01, 2025
GVHD prophylaxis with PTCy for HCT with MMUD
by Blood Advances
Raiola A, Bruno B, Risitano AM, et al. Post Transplant Cyclophosphamide as GVHD Prophylaxis in Patients Receiving Mismatched Unrelated HCT: The PHYLOS Trial. Blood Advances. 2025; (doi: 10.1182/bloodadvances.2024015173).
Phase II evidence supports the use of post-transplant cyclophosphamide (PTCy) as prophylaxis against acute graft-versus-host disease (aGVHD) in patients undergoing hematopoietic cell transplantation (HCT) from a mismatched unrelated donor (MMUD). In the PHYLOS study, investigators calculated the 100-day cumulative incidence (CI) of aGVHD among 77 patients with acute myeloid malignancies between January 2020 and November 2022. For the single-arm study, patients who underwent HCT from a MMUD received PTCy with busulfan and fludarabine. The rate at 100 days was 18.2% for grade II-IV disease and 6.5% for grade III-IV aGVHD. At 12 months, the CI of chronic GVHD was 13.4% (95% CI: 6.9-22.1). PTCy also mediated other clinical improvements in MMUD transplantation, including a low 1-year non-relapse mortality rate of 9.1% (95% CI: 4.0-16.9); relapse rate of 23.8% (95% CI: 14.9-33.9); and respective 1-year overall survival and graft-relapse-free survival rates of 78.6% (95% CI: 67.4-86.3) and 55.3% (95% CI: 43.4-65.7).
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