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

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.