Posttransplant cyclophosphamide beyond haploidentical transplantation

Area of Science:

• Hematology
• Immunology
• Transplantation Medicine

Background:

• Posttransplant cyclophosphamide (PTCy) has transformed haploidentical (Haplo) hematopoietic cell transplantation (HCT).
• Comparisons with unrelated donor (URD) transplants show PTCy offers comparable survival with reduced graft-versus-host disease (GVHD).

Purpose of the Study:

• To review the expanding applications of PTCy beyond haploidentical HCT.
• To evaluate PTCy's potential in matched related donor (MRD) and URD HCT settings.

Main Methods:

• Review of current literature and clinical practices regarding PTCy.
• Discussion of PTCy's use in various donor types (Haplo, MRD, URD) and conditions (e.g., peripheral blood, mismatched donors, post-checkpoint inhibitor therapy).

Main Results:

• PTCy demonstrates efficacy in reducing GVHD in haploidentical HCT.
• Emerging evidence suggests PTCy's potential applicability in MRD and URD HCT.

Conclusions:

• PTCy is becoming a new standard for GVHD prophylaxis in various HCT settings, including haploidentical, HLA-matched, and mismatched transplants.
• Further research is warranted to fully establish PTCy's role in allogeneic HCT.