Sirolimus is an acceptable alternative to tacrolimus for graft-versus-host disease prophylaxis after haploidentical peripheral blood stem cell transplantation with post-transplant

Among patients with hematologic malignancies who underwent allogeneic haploidentical donor (haplo) hematopoietic cell transplantation (HCT), those who received prophylaxis with sirolimus (SIRO) plus post-transplant cyclophosphamide (PTCy) and mycophenolate mofetil (MMF) and those who received prophylaxis with tacrolimus (TAC) plus PTCy and MMF experienced similar rates of grade II-IV acute GVHD (45% vs 47%, P = .6) at day +100 and chronic GVHD (47% vs 54%, P = .79) at 2 years post-HCT, according to data from a retrospective study. In multivariate analysis, neutrophil engraftment at day +30 was significantly better in the TAC group (odds ratio, 0.30; CI: 0.1–0.83, P = .02) with a median time to engraftment of 17 days vs 18 days for the SIRO group, but platelet engraftment was similar in both groups.