A medicine for transplant can raise the chance of infections
Cyclophosphamide is still helpful; patients should be watched for infections
Age2 years old and older
Number of Participants2,800
Research GoalImprove Survival
BMT from donated cells can cure blood cancers such as acute leukemia and MDS. But BMT can have a serious side effect called graft-versus-host disease (GVHD). In GVHD, the donated cells attack a patient’s organs. This can be serious.
A medicine called cyclophosphamide helps prevent GVHD. Cyclophosphamide allows people who don’t have a fully matched BMT donor to use a haploidentical, or half-matched donor. This helps more people get a transplant.
However, cyclophosphamide can raise the risk of infections in the first 6 months after transplant. Cyclophosphamide can prevent GVHD, but people need to get checked more closely for infections.
That’s from a study of about 2,800 people who got either cyclophosphamide or older medicines, called calcineurin inhibitors (CNI) to prevent GVHD.
Everyone got BMT during 2012-2017. They had BMT from either a fully matched or half-matched sibling. Everyone had either acute leukemia (AML or ALL) or myelodysplastic syndromes (MDS). Six months after BMT, people who got cyclophosphamide had more infections than people who got CNI:
A medicine called cyclophosphamide helps prevent GVHD. Cyclophosphamide allows people who don’t have a fully matched BMT donor to use a haploidentical, or half-matched donor. This helps more people get a transplant.
However, cyclophosphamide can raise the risk of infections in the first 6 months after transplant. Cyclophosphamide can prevent GVHD, but people need to get checked more closely for infections.
That’s from a study of about 2,800 people who got either cyclophosphamide or older medicines, called calcineurin inhibitors (CNI) to prevent GVHD.
Everyone got BMT during 2012-2017. They had BMT from either a fully matched or half-matched sibling. Everyone had either acute leukemia (AML or ALL) or myelodysplastic syndromes (MDS). Six months after BMT, people who got cyclophosphamide had more infections than people who got CNI:
- About half (1 in 2 people) who got cyclophosphamide had infections
- About one-third (1 in 3 people) who got CNI had infections.
People who did not get early infections, within 16 days after BMT, were slightly more likely to live longer. One year later:
- 61-68% (about 2 in 3 people) who had early infections were alive
- 66-71% (more than 2 in 3 people) who had no early infections were alive
People were more likely to have infections if they:
- Were older than 60
- Had severe leukemia or MDS
- Had GVHD
- Had low numbers of white blood cells
Infections can happen with both cyclophosphamide and CNI. Ask your doctor about treatments after BMT. There is a clinical trial using lower doses of cyclophosphamide to prevent GVHD