Cyclophosphamide Post Transplant

[NLJabbari]

Does anyone have experience or know of anyone who has been given Cyclophosphamide after BMT to prevent GVHD?

Once again we met with a BMT Doctor to discuss possible MUD BMT for my son. This is our third visit and thankfully it went quite well. The Dr. was very thorough in explaining various options and his overall recommendation.
He explained that given all the factors as they apply to my son's present condition, he felt that our best option at this time would be to treat with Solaris for PNH. He feels that a BMT is more than likely something that my son will need in the near future (1-2 years), but given the fact that the 4 "Potential" 9/10 possible donors are all a mismatch at the DRB1 Marker, he feels that the chance for GVHD greatly increases. He mentioned that currently, some centers are having some success with Cyclophosphamide post Transplant to prevent GVHD, but that not enough transplants using this method have been performed to claim victory. He believes that in a couple of years there will be a better understanding and possibly other options for transplants as well.

[Neil Cuadra]

Norma,

This article says that cyclophosphamide can help engraftment as well as prevent GVHD. I can see why it might make sense to wait for further studies and more statistics to confirm whether and how it should be used.

I often hear that if you need a transplant, the sooner you get it the better, so that's the other side of the question. If Solaris treatment controls the PNH for now, will Yashar be in a better or worse position for a transplant in a year or two? Since Solaris is fairly new, I suspect the doctors don't have a lot of data to go on there either. Luckily, you don't have to commit to a 1-2 year wait; you can treat the PNH for now and change your mind at any time.

Also, if you wait, a better-matched donor could surface.

[Marlene]

Norma,

Your best bet is to get a consult with Dr. Robert Brodsky at Hopkins. I know they are having some good success in refractory SAA patients but it's best to find out the details directly from him and he'll even give a few names of those who have gone through it.

One of the forum members, Karen, did the protocol for MDS. You can search her posts under mausmish here:

http://forums.marrowforums.org/membe...astposter&f=26

Marlene

[sbk007]

Norma, There's one drug called Prochymal that's approved in Canada for gvhd. When you goto the manufacturers website it sounds like a miracle drug. When you dig down further it doesn't get the fanfare you would want it to have. A lot of these methods to prevent gvhd are controversial because some studies show that while they might help with gvhd it comes at the price of increasing the risk of relapse, or survival, etc.

[NLJabbari]

Thank You Neil, Marlene, & sbk007, I will read the article and look into the info. you have shared.