Advancing Transplant Outcomes With Innovations in GVHD Prevention and Care

Partow Kebriaei, MD, Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, MD Anderson Cancer Center, discusses what factors may influence the decision for transplant in patients with acute lymphoblastic leukemia (ALL) and how experts determine who is best fit for transplant.

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0:09 | I think with regards to transplant and from the transplant side, we have made great strides, especially in the area of graft-vs-host disease prophylaxis. So, because of the great work pioneered by the group at Johns Hopkins, we can now use post transplant cyclophosphamide to reduce the risk for graft-vs-host disease and to allow us to transplant with mismatched donors.

0:37 | So, in order to be able to successfully perform a transplant, you have to have an available donor, and you have to have a fit patient. I think today, in 2024 we can say that most patients will have an available donor.

0:50 | The second is you have to have a fit patient. And I think again, this is where highly effective immunotherapies in ALL help us, because we are now talking about inducing, for instance, a person with Ph-positive ALL with a chemotherapy-free regimen, so the patient actually can get a transplant, if the patient, in fact, needs a transplant, and is very fit. So, for instance, in the chemotherapy-free regimen trial that was what was reported by the Italian group, in the group that did get a transplant following a chemotherapy-free regimen for Ph-positive ALL, the group that got transplanted had an extremely low treatment-related mortality rate. At the end, we are changing that group who does need a transplant, but hopefully we are also getting to transplant with more fit patients, and at the end of the day, then overall survival is improved for all patients.