title: Post-transplant high-dose cyclophosphamide for the prevention of graft-versus-host disease.
abstract: Cyclophosphamide's lack of hematopoietic stem cell toxicity and its unique effects on the immune system have prompted several investigators to explore its potential for the prevention of graft-versus-host disease (GVHD). In haploidentical hematopoietic stem cell transplants, post-transplant cyclophosphamide together with standard prophylaxis reduces the incidence of GVHD to acceptable rates without the need for T cell depletion. In matched related and unrelated donor settings, cyclophosphamide alone has produced encouraging results. In particular, the low incidence of chronic GVHD is noteworthy. Here, we present a review of the current understanding of the mechanism of action of post-transplant cyclophosphamide and summarize the clinical data on its use for the prevention of GVHD.
authors.affiliation: Blood and Marrow Transplantation Program, Spectrum Health, Grand Rapids, Michigan; Department of Medicine, Michigan State University, College of Human Medicine, Grand Rapids, Michigan. Electronic address: a.samer.al-homsi@spectrumhealth.org.
authors.forename: Ahmad Samer
authors.initials: AS
authors.lastname: Al-Homsi
authors.affiliation: Blood and Marrow Transplantation Program, Spectrum Health, Grand Rapids, Michigan.
authors.forename: Tara S
authors.initials: TS
authors.lastname: Roy
authors.affiliation: Blood and Marrow Transplantation Program, Spectrum Health, Grand Rapids, Michigan.
authors.forename: Kelli
authors.initials: K
authors.lastname: Cole
authors.affiliation: Blood and Marrow Transplantation Program, Spectrum Health, Grand Rapids, Michigan.
authors.forename: Yuxin
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Medicine, Michigan State University, College of Human Medicine, Grand Rapids, Michigan; Helen DeVos Children Hospital, Grand Rapids, Michigan.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Duffner
mesh_terms: D064591:Allografts; D003520:Cyclophosphamide / Q000627:therapeutic use*; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008212:Lymphocyte Depletion; D061349:Unrelated Donors
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide
keywords: Cyclophosphamide; GVHD; GVHD prevention