Uday R. Popat, MD, on the Future of Post-Transplant Cyclophosphamide to Prevent GVHD After Transplant for AML/MDS

CancerNetwork® spoke with 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, during the 2022 Tandem Meeting about protective regimens for graft-vs-host disease (GVHD) in patients receiving matched donor hematopoietic cell transplantation for acute myeloid leukemia or myelodysplastic syndrome. He spoke about a potential dosing schedules for cyclophosphamide that he thinks would be most beneficial.

At the meeting, he presented data regarding cyclophosphamide vs tacrolimus/methotrexate to prevent GVHD in patients with received myeloablative busulfan conditioning prior to their transplant.

Transcript:

I would modify my next study. You can take this example [to show how we can] further reduce GVHD or improve outcomes. There was a study reported by the [National Cancer Institute] at the [American Society of Hematology Annual Meeting and Exposition] where they reduced the dose of cyclophosphamide from 50 mg/kg for 2 days to 25 mg/kg for 2 days in a setting of haploidentical stem cell transplant. What they showed was impressive, with significantly better outcomes in terms of lower viral infection and faster than engraftment. That is an avenue we would like to pursue with our current studies in fractionated busulfan.

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.