New Study Shows Promise in Equalizing Outcomes for Transplant Patients

By Amanda Sangster - December 12, 2023

Racial and ethnic minority patients facing blood cancers have historically encountered challenges in finding HLA-matched donors for allogeneic stem cell transplants. Often relying on half-matched or mismatched unrelated donors, these patients face higher rates of death and graft-versus-host disease (GVHD).

Post-transplant cyclophosphamide (PTCy) is used to prevent graft-versus-host disease and allows for the transplantation of mismatched donors with outcomes comparable to perfectly matched donors. Despite this progress, a recent study investigated the drug’s effectiveness in racial and ethnic minority patients compared to their non-Hispanic white counterparts.

The study, led by Teresa Caprice, a physician assistant in the Department of Blood and Marrow Transplant and Cellular Immunotherapy at Moffitt Cancer Center, aimed to assess whether HLA-mismatched donor transplants with PTCy could eliminate existing disparities between racial and ethnic minority patients and white patients.

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"This breakthrough offers hope for a future where all patients, regardless of their racial or ethnic background, can benefit equally from this lifesaving procedure."

- Teresa Caprice, PA-C, Blood and Marrow Transplant and Cellular Immunotherapy Program

“Post-transplant cyclophosphamide is emerging as the new standard of care for graft-versus-host disease prophylaxis,” Caprice said. “However, there’s not enough data on how specifically racial and ethnic minorities are doing. That’s why we needed this study — to see if the positive impact extends to minority patients and if disparities still exist.”

Caprice presented the study results at the American Society of Hematology Annual Meeting in San Diego. She holds the distinction of being the first advanced practice provider from Moffitt to present an oral abstract at the annual meeting.

The retrospective analysis involved 302 adult patients who underwent haploidentical or mismatched- unrelated-donor transplants with PTCy at Moffitt between 2014 and 2022. The diverse cohort included non-Hispanic white, Hispanic-white, Black and other (Asian, biracial or multiracial) patients. Results were compared across these groups, considering various clinical endpoints.

Remarkably, the study found no significant differences in clinical outcomes between white and racial and ethnic minority patients. Key markers such as the cumulative incidence of acute graft-versus-host disease at day 100 and the two-year cumulative incidence of chronic GVHD, relapse, nonrelapse mortality, relapse-free survival and overall survival demonstrated comparable results among all patients.

The study is a significant stride toward eliminating health disparities in hematologic malignancy treatment outcomes. The findings underscore the importance of ongoing research and innovative strategies to ensure medical advancements are accessible and beneficial to all.

“Our research provides compelling evidence that post-transplant cyclophosphamide is a key factor in achieving equitable health care for racial and ethnic minority patients undergoing allogeneic hematopoietic cell transplant,” Caprice added. “It addresses disparities by expanding the donor pool and improving outcomes. This breakthrough offers hope for a future where all patients, regardless of their racial or ethnic background, can benefit equally from this lifesaving procedure.”

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