PGY2 Hematology/Oncology Pharmacy Resident NewYork-Presbyterian Hospital New York, New York, United States
Poster Abstract:
Background: Graft-versus-host disease (GVHD) is a significant complication of allogeneic hematopoietic stem cell transplant (HSCT). GVHD contributes to significant morbidity and mortality among recipients of allogeneic HSCT. Historically, GVHD prophylaxis at NewYork-Presbyterian/Weill Cornell Medical Center (NYP/WCMC) included a T-cell depletion approach, with the use of alemtuzumab and tacrolimus. In a recent phase 3 trial, post-transplant cyclophosphamide (PTCy) in combination with tacrolimus and mycophenolate mofetil demonstrated significantly more GVHD-free, relapse-free survival at one year as compared to the control group (tacrolimus and methotrexate).1 Based on these findings, NYP/WCMC transitioned from alemtuzumab-based GVHD prophylaxis to PTCy. This retrospective analysis aims to offer real-world insight into the use of PTCy compared to alemtuzumab as prophylaxis against GVHD.
Objective(s): The primary outcome of this study is to compare the cumulative incidence of acute GVHD at day 100 between alemtuzumab and PTCy in patients who received a matched related or matched unrelated allogeneic HSCT. Secondary outcomes include time to neutrophil and platelet engraftment, immune reconstitution, disease relapse or progression within 100 days, 100-day survival, rates of infections, and incidence of hemorrhagic cystitis.
Methods: This is an IRB approved retrospective cohort study at NYP/WCMC that included adult patients who underwent a matched related or matched unrelated donor allogeneic HSCT between March 2022 and September 2023. Statistical analyses will be performed using Stata 14.2.
Results: Results pending.
Discussion/
Conclusion: Results pending.
References (must also be included in final poster): 1. Bolaños-Meade J, Hamadani M, Wu J, et al. Post-Transplantation Cyclophosphamide-Based Graft-versus-Host Disease Prophylaxis. N Engl J Med. 2023;388(25):2338-2348. doi:10.1056/NEJMoa2215943
