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Awais Ijaz from the University of Arizona, Tucson, AZ, USA, and colleagues retrospectively evaluated the safety, efficacy and risks of checkpoint inhibitors (CPIs) in patients with hematological malignancies undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). CPIs can enhance graft versus tumor (GVT) effect, whereas the risk of graft-versus-host disease (GvHD) may increase. The study was published in Biology of Blood and Marrow Transplantation.
Twenty-four articles (13 case reports and 11 original manuscripts) were selected from PubMed regarding CPIs administered for patients with hematological malignancies either before or after allo-HSCT.
The authors concluded that the rate of acute GvHD was high (56%) in patients who received CPI therapy prior to allo-HSCT. They added that “this rate is higher than the historical incidence that ranges between 26% to 50%.” In addition, CPIs received after allo-HSCT led to superior efficacy, but also increased the risk of GvHD (14% acute, 9% chronic). The study group further stated that “there is need for extreme caution while making decisions regarding the use of CPI.” Further prospective clinical trials are required to confirm these findings.
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