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EHA 2019 | Should we use PTCy or ATG as GvHD prophylaxis in haploidentical stem cell transplantation?
Featured:
Arnon NaglerAt the 24th Congress of the European Hematology Association (EHA), Arnon Nagler from the Tel Aviv University, Tel Aviv, IL, discusses whether prophylactic post-transplant cyclophosphamide (PTCy) or anti-thymocyte globulin (ATG) provides a better outcome for patients with acute myeloid leukemia (AML) who are at risk of developing graft-versus-host disease (GvHD).
Professor Nagler discusses GvHD prophylaxis in haploidentical stem cell transplant (haplo-SCT), noting two main strategies; using ATG or using PTCy. In trials in patients with AML, based on the EBMT registry, PTCy improved overall survival, leukemia-free survival and GvHD-relapse free survival benefit compared to ATG. In a recent study, the group looked at outcomes of patients with acute lymphoblastic leukemia (ALL), also finding a benefit of PTCy over ATG in haplo-SCT.
Professor Nagler concluded there is more and more data in the European population that PTCy is better for prevention of GvHD compared to ATG. However, a two-arm study would be necessary to prove this.
Should we use PTCy or ATG as GvHD prophylaxis in haploidentical stem cell transplantation?