HealthDay News – For patients undergoing myeloablative allogeneic hematopoietic stem cell transplantation, sitagliptin combined with tacrolimus and sirolimus results in a low incidence of grade II to IV acute graft-versus-host disease (GVHD) by day 100, according to a study published in the January 7 issue of the New England Journal of Medicine.

Sherif S. Farag, MD, PhD, from the Indiana University School of Medicine in Indianapolis, and colleagues conducted a phase 2 clinical trial to examine the reduction in incidence of grade II to IV acute GVHD from 30% to no more than 15% by day 100 with sitagliptin plus tacrolimus and sirolimus. Thirty-six patients received myeloablative conditioning followed by mobilized peripheral-blood stem cell transplants from matched related or unrelated donors.

The researchers found that by day 100, acute GVHD occurred in 2 of 36 patients. The incidence of grade II to IV GVHD and of grade III or IV GVHD was 5 and 3%, respectively. At 1 year, nonrelapse mortality was zero. The 1-year cumulative incidence of relapse was 26%, and for chronic GVHD, it was 37%. At 1 year, GVHD-free, relapse-free survival was 46%. Toxic effects were similar to those seen in patients undergoing allogeneic stem cell transplantation.

“Inhibition of dipeptidyl peptidase 4 should be further investigated in randomized trials that compare sitagliptin with current standard GVHD prophylaxis regimens,” the authors write.


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Two authors disclosed financial ties to the biopharmaceutical industry.

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