High-dose, post-transplant cyclophosphamide can successfully reduce severe graft-versus-host disease (GVHD) after T-cell-replete allogeneic transplantation for AML, ALL, and MDS, using related and unrelated donors. This retrospective study included 209 adults who underwent myeloablative transplantation and received post-transplant cyclophosphamide as the sole GVHD prophylaxis. Cumulative incidences of grades II-IV and grades III-IV acute GVHD at 100 days were 45% and 11%, respectively, and chronic GVHD at 2 years was 13%. Forty-three percent of patients did not require immunosuppression for any reason beyond post-transplant cyclophosphamide. Transplant-related mortality at 3 years was 15%, which Dr. Olle Ringdén noted in an editorial discussing the study was much lower than what is generally seen with a calcineurin inhibitor combined with a short arm of methotrexate.
Post-HCT Cyclophosphamide is Effective as Sole GVHD Prophylaxis