Is Post-Transplant Cyclophosphamide the New Methotrexate?
Alberto MussettiAnnalisa PaviglianitiRocio ParodyAnna SuredaPublished in: Journal of clinical medicine (2021)
Introducing post-transplant, cyclophosphamide (PT-Cy) graft-versus-host disease (GVHD) prophylaxis in the setting of haploidentical donor transplantation has marked the most important advance in allogeneic hematopoietic cell transplantation (alloHCT) within the past 15 years. The efficacy of this procedure and its simple features have allowed for the significantly widespread application of alloHCT worldwide. Indeed, the procedure's effectiveness in reducing immunological complications in the haploidentical setting has even challenged the status quo use of calcineurin-inhibitor, methotrexate-based GVHD prophylaxis in the setting of HLA-identical donors. Currently, however, prospective clinical trials in support of PT-Cy-based GVHD prophylaxis in the HLA-matched setting are striving to resolve the matter of its potential role. This review will briefly report the overall outcomes of PT-Cy-based GVHD prophylaxis in the haploidentical setting and summarize results obtained in the HLA-identical field. We will present future perspectives at the end of the manuscript.
Keyphrases
- stem cell transplantation
- high dose
- bone marrow
- allogeneic hematopoietic stem cell transplantation
- clinical trial
- low dose
- peripheral blood
- randomized controlled trial
- systematic review
- minimally invasive
- stem cells
- cord blood
- acute lymphoblastic leukemia
- risk factors
- acute myeloid leukemia
- adipose tissue
- insulin resistance
- cell therapy