Who said you can’t teach an old drug new tricks? The use of post-transplant cyclophosphamide for acute graft-versus-host disease prevention

January 28, 2021

aGVHD occurs when the donor’s immune cells recognize the recipient’s body as foreign and consequently attack the body. The risk of aGVHD post-transplant increases the risk of complications, morbidity and mortality post allogeneic transplant. aGVHD presents usually anywhere between 10-100 days post-transplant. About ~40-50% of our allogeneic transplant recipients are affected by aGVHD, with the highest incidence in our matched unrelated or mismatched allogeneic stem cell transplant recipients. Patients usually present first with symptoms of generalized maculopapular rash throughout the entire body and/or upper gastrointestinal tract symptoms consisting of nausea, anorexia or both. Patients will also experience lower gastrointestinal tract symptoms such as watery diarrhea, severe abdominal pain, bloody diarrhea or an ileus. aGVHD can also affect the liver causing hyperbilirubinemia. Traditionally, prevention methods for aGVHD differ per institution. Standard of care prevention usually consists of methotrexate and a calcineurin inhibitor; while mTOR inhibitors and mycophenolate are other preventative methods. T cell depletion methods such as alemtuzumab, thymoglobulin, and post-transplant cyclophosphamide are alternative methods used for the prevention of aGVHD. New published data has expanded on the use of post-transplant cyclophosphamide. Post-transplant cyclophosphamide compared to other t cell depletion methods has produced similar overall survival rates with lower incidence of side effects. This presentation will review primary literature on post-transplant cyclophosphamide utilization to prevent aGVHD. By presenting evidence-based medicine on post-transplant cyclophosphamide, this presentation will help explain to the institution’s pharmacy team the importance of this emerging method used to prevent aGVHD.

Target Audience

  • Pharmacists
  • Pharmacy technicians

Learning Objectives

Pharmacist learning objectives

  1. Explain the pathophysiology of acute graft versus host disease (aGVHD)
  2. Review the clinical signs and symptoms of aGVHD
  3. Determine the adverse effects caused by the therapeutic agents used for the prevention of aGVHD
  4. Evaluate the literature on the recent advancements in therapies used for prevention of aGVHD

Pharmacy technician learning objectives

  1. Recognize brand and generic names of pharmacological options used for the prevention of acute graft versus host disease
  2. Identify the different dosage forms of the pharmacological options used for the prevention of aGVHD
Course summary
Available credit: 
  • 1.00 ACPE Pharmacist
  • 1.00 ACPE Pharmacy Technician
  • 1.00 General CE - Attendance
Course opens: 
Course expires: 
Event starts: 
01/28/2021 - 12:00pm CST
Event ends: 
01/28/2021 - 1:00pm CST
Ochsner Medical Center
New Orleans, LA
United States
Relevant financial relationships: Planning committee members and presenters have nothing to disclose
The presenter will discuss off-label use of drugs
Planning committee members
Jessica Foy, PharmD, BCPS, BCOP
Clinical Pharmacy Specialty, Bone Marrow Transplant
Ochsner Medical Center
Breanne Peyton-Thomas, PharmD, BCOP
Clinical Pharmacy Speciality, Bone Marrow Transplant
Ochsner Medical Center
Bailey Wise, PharmD, BCPS
Clinical Pharmacist
Ochsner Medical Center
Shima Shafiyan, PharmD
PGY-2 Oncology Pharmacy Resident
Ochsner Medical Center
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Vizient, Inc. and Ochsner Medical Center.  Vizient, Inc. is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Designation Statements:
Vizient, Inc. designates this activity for a maximum of 1.00 ACPE credit hours.
Universal Activity Number: JA0006103-9999-21-077-L01-P
Universal Activity Number: JA0006103-9999-21-077-L01-T
Vizient, Inc. will award CEUs to each participant who successfully completes this program. The CEU is a nationally recognized unit of measure for continuing education and training programs that meet certain criteria (1 contact hour = 0.1 CEU).

Available Credit

  • 1.00 ACPE Pharmacist
  • 1.00 ACPE Pharmacy Technician
  • 1.00 General CE - Attendance
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