Jun 18, 2026 · 29 min · 11 segments
In this episode of *ASTCT Talks,* host Dr. Corey Cutler, MD, from Dana-Farber Cancer Institute, is joined by Dr. Pooja Khandelwal, MD (Cincinnati Children’s Hospital), Dr. Ben Watkins, MD (Tulane…
Ken CookeGuest
Corey CutlerHost
Pooja KhandelwalGuest
Ben WatkinsGuest
I'm not talking about the N of one, which I know my colleagues in pediatrics are all specialists in.
But Ken, the majority of your patients that come through your program, tell me about their GvHD prevention strategy.
I will start first by saying, you know, I was kind of, uh, raised professionally having trained at the Dana-Farber and Boston Children's Hospital, and then moving on to Michigan, really kind of focused on your gold standard methotrexate calcinorin inhibitor-based GvHD prophylaxis because our translational research portfolio at those times always included the addition of a novel agent which may have been tested in some of our animal models.
I could go into details later, but this is basically based on efficacy, simplicity, and really versatility of the regimen as our group and others are now showing that PTSI platforms can be used across the entire spectrum of BMT indications for pediatric patients from liquid and solid malignancies, to hemoglobinopathies and marrow failure, to immune deficiencies and dysregulatory syndromes.
Our standard approach for selecting an acute graft versus host disease prophylaxis strategy is based on several factors, but traditionally we select a calcineurin inhibitor with a second agent, oftentimes either methotrexate or mycophenolate, and if possible, try and combine that with abatacept, as we have found it to be extremely well-tolerated and quite effective in reducing acute graft versus host disease.
Our center specifically has also incorporated the use of vitamin A for acute GvH prevention in addition to these agents.
So I see we're gonna have something to talk about today based on the first two responses.
[laughs] Ben, why don't you tell us at Tulane, I suspect we know how that's gonna play out.
Well, actually I think our group, it's nice to go third because I think we kind of fall into the middle a little bit.
We do use a lot of abatacept, especially for our matched unrelated donors, some of our matched sibs, but our mismatched we usually choose between PTSI or ID patient factors, and then our haploidentical setting is, is gonna be a, be PTSI.
We have experience and have used post-transplant cyclophosphamide in our haploidentical transplant patients.
Oftentimes, that is not our first approach, though I would say it is a balance between using a CD34-selected graft versus post-transplant cyclophosphamide.
I'm not talking about the N of one, which I know my colleagues in pediatrics are all specialists in.
But Ken, the majority of your patients that come through your program, tell me about their GvHD prevention strategy.
I will start first by saying, you know, I was kind of, uh, raised professionally having trained at the Dana-Farber and Boston Children's Hospital, and then moving on to Michigan, really kind of focused on your gold standard methotrexate calcinorin inhibitor-based GvHD prophylaxis because our translational research portfolio at those times always included the addition of a novel agent which may have been tested in some of our animal models.
I could go into details later, but this is basically based on efficacy, simplicity, and really versatility of the regimen as our group and others are now showing that PTSI platforms can be used across the entire spectrum of BMT indications for pediatric patients from liquid and solid malignancies, to hemoglobinopathies and marrow failure, to immune deficiencies and dysregulatory syndromes.
Our standard approach for selecting an acute graft versus host disease prophylaxis strategy is based on several factors, but traditionally we select a calcineurin inhibitor with a second agent, oftentimes either methotrexate or mycophenolate, and if possible, try and combine that with abatacept, as we have found it to be extremely well-tolerated and quite effective in reducing acute graft versus host disease.
Our center specifically has also incorporated the use of vitamin A for acute GvH prevention in addition to these agents.
So I see we're gonna have something to talk about today based on the first two responses.
[laughs] Ben, why don't you tell us at Tulane, I suspect we know how that's gonna play out.
Well, actually I think our group, it's nice to go third because I think we kind of fall into the middle a little bit.
We do use a lot of abatacept, especially for our matched unrelated donors, some of our matched sibs, but our mismatched we usually choose between PTSI or ID patient factors, and then our haploidentical setting is, is gonna be a, be PTSI.
We have experience and have used post-transplant cyclophosphamide in our haploidentical transplant patients.
Oftentimes, that is not our first approach, though I would say it is a balance between using a CD34-selected graft versus post-transplant cyclophosphamide.
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