Abstract
Purpose :
Chronic ocular Graft-versus-host disease (oGVHD) affects up to 60% of patients after allogeneic haematopoietic cell transplantation (aHCT). As a foreseeable disease, prevention of oGVHD should be feasible, however so far no effective preventive approach has been established. Posttransplant cyclophosphamide (PT-Cy) has been demonstrated to avoid non-ocular GVHD, but has not yet been tested for preventive efficacy in oGVHD. The purpose of this study was to investigate oGVHD in patients following PT-Cy prophylaxis after aHSCT.
Methods :
We retrospectively analysed 63 consecutive patients that underwent aHCT at a single centre between May 2011 and January 2023, receiving PT-Cy. Non-ocular baseline characteristics including main diagnosis, donor relationship, GVHD prophylaxis and systemic GVHD were assessed together with data from ophthalmic examinations.
Results :
From all patients receiving PT-Cy, 37 patients were included (mean age 48.4 years±15.14), who underwent post-transplant ophthalmological examination. The proportion of patients developing chronic oGVHD who received PT-Cy (40.54%) was comparable to the prevalence in a Cologne cohort (n=213) of 1-year survivors (40%). Patients, transplanted under adverse-environmental conditions (Oct-Feb) developed oGHVD in 47,6% vs. 31,3% of patients transplanted under non-desiccating conditions (Mar-Sept).
Conclusions :
In conclusion, PT-Cy demonstrates only limited effect on the development of chronic oGVHD. This supports the hypothesis, that pathogenesis of oGVHD occurs at least partially independent from systemic GVHD. Furthermore, environmental risk factors may override systemic anti-inflammatory therapies and should be considered in the development and testing of novel prophylactic regimen.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.