Posttransplant cyclophosphamide beyond haploidentical transplantation

Ann Hematol. 2024 May;103(5):1483-1491. doi: 10.1007/s00277-023-05300-8. Epub 2023 Jun 1.

Abstract

Posttransplant cyclophosphamide (PTCy) has practically revolutionized haploidentical (Haplo) hematopoietic cell transplantation (HCT). Comparisons between Haplo with PTCy and unrelated donor (URD) with conventional graft-versus-host disease (GVHD) prophylaxis have shown comparable overall survival with lower incidences of GVHD with Haplo/PTCy and led to the following question: is it PTCy so good that can be successfully incorporated into matched related donor (MRD) and URD HCT? In this review, we discuss other ways of doing PTCy, PTCy in peripheral blood haploidentical transplants, PTCy in the context of matched related and matched unrelated donors, PTCy with mismatched unrelated donors, and PTCy following checkpoint inhibitor treatment. PTCy is emerging as a new standard GVHD prophylaxis in haploidentical, HLA-matched, and -mismatched HCT.

Keywords: Bone marrow; HLA-matched; HLA-mismatched; Haploidentical; Hematopoietic cell transplantation; Peripheral blood stem cells; Posttransplant cyclophosphamide.

Publication types

  • Review

MeSH terms

  • Cyclophosphamide / therapeutic use
  • Graft vs Host Disease* / drug therapy
  • Graft vs Host Disease* / etiology
  • Graft vs Host Disease* / prevention & control
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Retrospective Studies
  • Transplantation, Haploidentical
  • Unrelated Donors

Substances

  • Cyclophosphamide