Post-Transplant Cyclophosphamide in Allogeneic Peripheral Blood Stem Cell Transplantation from Fully HLA- Matched Sibling Donors in Adult Egyptian Patients with Severe Aplastic Anemia

Abstract

Graft versus host disease (GvHD) is still considered a huge cause of morbidity and mortality in patients with severe aplastic anemia (SAA) who have Hematopoietic stem cell transplantation (HSCT). Objectives: our study aimed at evaluating the effectiveness of post-transplant cyclophosphamide (PTCY) as a GvHD prophylaxis in adult Egyptian patients with SAA. Materials and Methods: sixty patients with SAA who had allogeneic HSCT were divided into; Group I: 30 patients received cyclophosphamide (CY) plus cyclosporine A (CsA) as a GvHD prophylaxis regimen. Group II: 30 patients (historical controls) had received CsA and short-term methotrexate as a GvHD prophylaxis regimen (old regimen). Results: acute GvHD (aGvHD) incidence was 6.7% in group I, and 36.7% in group II. Chronic GvHD (cGvHD) occurred in 10% ,56.7% of patients in group I and II, respectively and overall survival (OS) was 70% in group I, versus 56.7% in group II. Conclusions: we concluded that PTCY / CsA showed a significant reduction in the rate of both acute and chronic GvHD with superior OS than the old regimen.