Uday R. Popat, MD, reviews post-transplant cyclophosphamide versus tacrolimus and methotrexate for preventing GVHD in AML/MDS
Uday R. Popat, MD, discussed how effective post-transplant cyclophosphamide vs tacrolimus plus methotrexate in preventing graft versus host disease was in this trial.
Uday R. Popat, MD, professor and acting vice chair of the Department of Stem Cell Transplantation, Division of Cancer Medicine, at the University of Texas MD Anderson Cancer Center in Houston, spoke with CancerNetwork® during of the Tandem Meeting 2022 on the results observed with the post-transplant use of cyclophosphamide compared with tacrolimus plus methotrexate to prevent graft versus host disease (GVHD) in patients with acute myeloid leukemia and myelodysplastic syndrome who have undergone a transplant of hematopoietic cells from a matched donor after myeloablative busulfan. The treatment used in the trial (NCT02250937) helped reduce severe GVHD and relapse-free mortality.
Post-transplant cyclophosphamide, as expected, reduced severe GVHD after a myeloablative diet. The rate of acute severe GVHD was 17% in the tacrolimus plus methotrexate arm and decreased to 4% [with cyclophosphamide], almost a reduction of 4 times. This then translated to a 4-fold reduction in treatment-related or non-relapse mortality. Mortality in tacrolimus-plus-methotrexate [arm] was 24% and it was reduced to 6%. This then translated into better survival. It was 85% vs 41% at 1 year and 69% vs 38% at 3 years. These are impressive results.
Popat UR, Mehta Rs, Bassett R, et al. Post-transplant cyclophosphamide versus tacrolimus and methotrexate for preventing graft-versus-host disease in matched-donor transplant recipients: comparison of sequential cohorts in a prospective trial. Presented at the 2022 Tandem Meeting; Salt Lake City, Utah; April 23-26, 2022. Poster 379.