Graft-versus-host disease (GVHD) is a major complication following allogeneic hematopoietic stem cell transplant (HSCT) and is the leading cause of nonrelapse mortality in patients surviving more than 2 years. The additional immunosuppressive therapy to treat GVHD further increases the patient’s risk of developing life-threatening infections, organ toxicity, and disease relapse.
Recent studies show that using high-dose cyclophosphamide early after HSCT does not compromise engraftment and can decrease the risk of acute and chronic GVHD. This presentation will review the history of GVHD prophylaxis and treatment, the pharmacology of the medications currently used, and then focus on the newest strategy to decrease GVHD using post-transplant cyclophosphamide.
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