Description:
Over the last few decades, significant progress in reducing infectious and immune-related complications of allogeneic hematopoietic cell transplantation have improved the feasibility and overall outcome of this complex procedure. Still, in patients patients transplanted for malignant diseases, reappearance of the original cancer, or relapse, continue to represent a crucial clinical issue. This educational session will present current knowledge on the biology of relapse, on how to tailor the transplant protocol to reduce its incidence, and on the use of novel drugs to prevent or treat recurrence.

Dr. Luca Vago will outline available evidence on the dynamic changes occurring in cancer cells and the patient immune system upon allogeneic hematopoietic cell transplantation, with a particular focus on how key aspects of the transplant such as donor choice and use of specific drugs impact on disease evolution, and on how state-of-the-art profiling of relapsed disease can help selecting appropriate countermeasures.

Dr. Ito's session begins by highlighting the current evidence of maintenance therapy for post-transplant relapse prevention, including targeted therapies, hypomethylating agents, venetoclax, and immunotherapies. The talk then shifts the focus to the role of relapse monitoring, emphasizing the importance of measurable residual disease and donor chimerism. Finally, the session will review the salvage therapies for overt relapse, including donor lymphocyte infusion, second allogeneic stem cell transplantation, and selected agents under investigation.

Dr. Pierini will speak on novel conditioning and prophylaxis regimens for relapse prevention.