2020 innovations in the field of hematopoietic stem cell transplantation

Raphaël Lattenist, MD, Xavier Poiré, MD, PhD Published in the journal : February 2021 Category : Hematology/Oncology

Summary :

The 2020 annual meeting of the American Society of Hematology (ASH) provided us with several contributions to the field of hematopoietic stem cell transplantation (HSCT). Post-transplant cyclophosphamide (PTCy) occupied a prominent place on the stage. This modality of graft-versus-host disease (GvHD) prophylaxis, which was initially developed in the haploidentical HSCT setting, was associated with major benefits so that its use tended to spread across other donor types. PTCy appears to be particularly invested with the benefit of improving outcomes in HSCT from mismatched unrelated donors (MMUD). This appears to be of great usefulness for patients from underserved ethnicities that lack a matched donor. Likewise, management of chronic graft-versus-host disease (cGvHD) had its share of improvement with the result presentation of the REACH3 study. Notably, in this study, ruxolitinib was compared to the best available therapy. The approach of reduced intensity conditioning (RIC) for myeloid malignancies similarly received some attention with a boost to supporting its use for higher-risk myelodysplastic syndrome (MDS), including the elderly. Finally, we present a Phase 1 study, which was designed to improve its efficacy in high-risk myeloid malignancies by adding venetoclax .

Key Words

ALL, AML, graft-versus-host disease, hematopoietic stem cell transplantation, haplo-identical, myelodysplastic syndromes, post-transplant cyclophosphamide, reduced intensity conditioning regimen, ruxolitinib, venetoclax.