Comparison of Post-transplant Cyclophosphamide Containing Immunosuppressive Regimen with Standard Immunosuppressive Regimen in Allogeneic Stem Cell Transplantation from Matched Sibling Donor

• Published in: Namık Kemal tıp dergisi Vol. 9; no. 3; pp. 269 - 275
• Main Authors: KARA, Osman, ELİBOL, Tayfun
• Format: Journal Article
• Language: English
• Published: Galenos Yayınevi 01.12.2021; Galenos Yayincilik
• Subjects: allogeneic stem cell transplant; cyclophosphamide; graft-versus-host disease; Tıp; Tekirdağ; Türkiye; graft-versus host disease; siklofosfamid; cyclophosphamide; Allojenik kök hücre nakli; graft-versus-host disease; Allogeneic stem cell transplant
• ISSN: 2587-0262; 2587-0262
• DOI: 10.4274/nkmj.galenos.2021.91300

Aim: Allogeneic stem cell transplantation (ASCT) is the only treatment that can cure most of malignant hematological diseases with the risk of some serious complications such as graft-versus-host disease (GVHD). GVHD can be got under control with post-transplant cyclophosphamide even in patients with haploidentical stem cell transplants. Here, we aimed to compare the effectiveness of post-transplant cyclophosphamide on GVHD with standard immunosuppressive therapy. Materials and Methods: Patients with high-risk hematologic malignancies, who received ASCT from human leukocyte antigen-matched sibling donors, were studied. Patients in the post-transplant cyclophosphamide group also used tacrolimus and mycophenolate mofetil; on the other side, standard immunosuppressive treatment with cyclosporine and methotrexate was used. The primary endpoint of the study was to compare the severe acute GVHD rate between the groups. Results: A total of 40 patients were included in the study. While severe (grade 3-4) GVHD was seen in three patients in the methotrexate-cyclosporin group, it was not seen in any patient in the post-transplant cyclophosphamide group. Also, 10th-month progress-free survival and overall survivals were 78.8% and 93.3% vs 56% and 72% in the post-transplant cyclophosphamide group and methotrexate-cyclosporin group, respectively. Conclusion: Cyclophosphamide can be the cheapest, most applicable, and clinically effective treatment in GVHD prophylaxis.