More about post-transplant cyclophosphamide in haploidentical grafts: full or reduced doses?

• Published in: Hematology (Luxembourg) Vol. 29; no. 1; p. 2313357
• Main Authors: Gallardo-Pérez, Moisés Manuel, Gutiérrez-Aguirre, César Homero, Olivares-Gazca, Juan Carlos, Ruiz-Argüelles, Guillermo José
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Group 01.12.2024
• Subjects: Allogeneic hematopoietic stem cell transplantation; allograft; Cyclophosphamide - adverse effects; cytokine release syndrome; Graft vs Host Disease - etiology; graft-versus-host disease; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - methods; Humans; outpatient; post-transplantation cyclophosphamide; Recurrence; Transplantation Conditioning - adverse effects; Allogeneic hematopoietic stem cell transplantation; post-transplantation cyclophosphamide; acute leukemia; haploidentical hematopoietic stem cell transplantation; cytokine release syndrome; outpatient; allograft; graft-versus-host disease
• ISSN: 1607-8454; 1607-8454
• DOI: 10.1080/16078454.2024.2313357

Haploidentical hematopoietic can be conducted on an outpatient basis but the two main reasons to accept into the hospital a patient in this setting are complications of the hematological toxicity and/or the cytokine-release syndrome. With the aim of reducing the post-transplant cyclophosphamide-dependent toxicity without compromising its effectivity, attempts to reduce the dose of post-transplant cyclophosphamide have been made: Decreases from the conventional total dose of post-transplant cyclophosphamide (100 mg/Kg) have been explored worldwide, showing that decreasing the total dose to even 50 mg/Kg significantly decreases the toxicity of the procedure without compromising its efficacy, safety and results. We present here the salient data of the attempts to diminish the doses of post-transplant cyclophosphamide which have been done and published worldwide, information that suggests that the conventional doses of post-transplant cyclophosphamide can be significantly reduced thus decreasing the toxicity, without compromising the effectiveness of the procedure, mainly the development of graft host disease.