# The Effect of Post-Transplant Cyclophosphamide Administration on Graft-Versus-Host Disease in Allogeneic Bone Marrow Transplantation

## TL;DR

This study shows that giving cyclophosphamide after a bone marrow transplant reduces the risk of graft-versus-host disease in patients.

## Contribution

The study demonstrates that post-transplant cyclophosphamide significantly decreases both acute and chronic GVHD in allogeneic stem cell transplantation.

## Key findings

- Acute GVHD occurred less frequently in patients who received post-transplant cyclophosphamide.
- Chronic GVHD was significantly more common in patients who did not receive post-transplant cyclophosphamide.
- Overall survival was higher in patients with good AML cytogenetic risk and those transplanted in first remission.

## Abstract

This study aimed to investigate the effect of post-transplant cyclophosphamide (PTcy) use on graft-versus-host disease in patients undergoing allogeneic stem cell transplantation. 78 patients who underwent transplantation at our hospital were included in this study. Our findings showed that in all transplantation types, the development of acute and chronic GVHD significantly less frequently in the group that received PTcy.

Aim: In this study, we aimed to compare patients receiving PTcy with those receiving standard graft-versus-host disease (GVHD) prophylaxis in terms of GVHD development, disease relapse, overall survival, transplant-related mortality, and infection development Methods: Data from 78 patients who underwent allogeneic stem cell transplantation (AHSCT) at Medicana Izmir Hospital between January 2022 and June 2024 were retrospectively evaluated. Results: Myeloablative-related AHSCT was performed on 38 patients (48.7%), myeloablative-unrelated AHSCT was performed on 26 patients (33.3%), and haploidentical AHSCT was performed on 14 patients (17.9%). Acute GVHD was observed in 42 patients (53.8%); it was observed significantly less frequently in the group that received PTcy (p = 0.032) In 15 patients (19.2%), chronic GVHD developed following acute GVHD. It was found that chronic GVHD occurred more frequently in those who did not receive PTcy (p = 0.0001), in sibling transplants (p = 0.037), in those without febrile neutropenia (p = 0.021), and in those with high CMV-DNA levels (p = 0.040). The median OS (months) was found to be 79.16 months. The median OS (months) was higher in patients in the good AML cytogenetic risk group (p < 0.001) and in those who underwent transplantation in first remission (p = 0.021). Conclusions: PTcy significantly reduced the development of acute and chronic GVHD.