Uday R. Popat, MD, Reviews Post-Transplant Cyclophosphamide Vs Tacrolimus and Methotrexate to Prevent GVHD in AML/MDS

Uday R. Popat, MD, professor and deputy chair ad interim in the Department of Stem Cell Transplantation, Division of Cancer Medicine, at the University of Texas MD Anderson Cancer Center in Houston, spoke to CancerNetwork® during the 2022 Tandem Meeting about the results observed with post-transplant cyclophosphamide use vs tacrolimus plus methotrexate to prevent graft-vs-host disease (GVHD) for patients with acute myeloid leukemia and myelodysplastic syndrome who underwent a matched donor hematopoietic cell transplantation after myeloablative busulfan. The treatment utilized in the trial (NCT02250937) helped to reduce severe GVHD and nonrelapse mortality.

Transcript:

Post-transplant cyclophosphamide, as expected, reduced severe GVHD after a myeloablative regimen. The acute severe GVHD rate was 17% in the tacrolimus plus methotrexate arm and it went down to 4% [with cyclophosphamide], almost a 4-fold reduction. This then translated into a 4-fold reduction in treatment-related or nonrelapse mortality. Mortality in the tacrolimus-plus-methotrexate [arm] was 24% and it was reduced to 6%. This then translated into better survival. That was 85% vs 41% at 1 year and 69% vs 38% at 3 years. These were impressive results.

Reference

Popat UR, Mehta Rs, Bassett R, et al. Post-transplant cyclophosphamide versus tacrolimus and methotrexate to prevent graft-versus-host-disease in recipients of matched donor transplantation: comparison of sequential cohorts in a prospective trial. Presented at the 2022 Tandem Meeting; Salt Lake City, Utah; April 23-26, 2022. Poster 379.