De-escalated PTCy + ruxolitinib for GvHD prophylaxis

During the Transplant & Cellular Therapy Meetings of ASTCT and CIBMTR (2026 Tandem Meetings), February 4–7, 2026, Salt Lake City, US, Sameen Abedin presented results from a prospective phase II study (NCT05622318), evaluating de-escalated post-transplant cyclophosphamide (PTCy; 25 mg/kg/day) + ruxolitinib for graft-versus-host disease (GvHD) prophylaxis in older patients (aged ≥60 years; N = 56) undergoing reduced intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (allo-HSCT) from a human-leukocyte antigen (HLA)-matched donor. The primary endpoint was GvHD-free survival (GFS) at 1 year.

Key data: GFS at 1 year was 75.8% (95% confidence interval [CI], 58.1–86.8); GvHD-free relapse-free survival (GRFS) at 1 year was 75% (95% CI, 64.1–92.2). The cumulative incidence of Grade 3–4 acute GvHD (aGvHD) at Day 180 was 4.0% (95% CI, 1.1–15), and the cumulative incidence of chronic GvHD (cGvHD) requiring immunosuppression at 1 year was 7.0% (95% CI, 1.8–25). Median time to neutrophil and platelet engraftment was 13 days (range, 6–33) and 13 days (range, 10–37) post-HSCT, respectively. Grade 2–3 infections within the first 100 days occurred in 10.8% (95% CI, 5.1–22.3) of patients.  

Key learning: Among patients aged ≥60 years undergoing RIC allo-HSCT, de-escalated PTCy + ruxolitinib demonstrates rapid engraftment, low infection burden, and favorable 1-year GFS, supporting further evaluation of this approach to improve post-transplant outcomes in this population.