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EBMT 2026 | Graft manipulation in the PTCy-era

Antonio Pérez-Martínez, MD, PhD, Autonomous University of Madrid, Madrid, Spain, shares insights into graft manipulation in the era of post-transplant cyclophosphamide (PTCy). He notes that while PTCy may be more affordable and accessible, graft manipulation allows greater control over cell properties, may eliminate the need for additional drugs, and has yielded beneficial outcomes in pediatric cohorts. This interview took place at the 52nd Annual Meeting of the EBMT in Madrid, Spain.

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Transcript

As I understand, bone marrow transplant is the evolution of what Donald Thomas did 50, 60 years ago. However, the bone marrow transplant so far is very… we use a lot of chemicals, a lot of drugs. So to me, bone marrow transplant evolution is a cell therapy evolution. So this is why graft manipulation allows us to control and to incorporate the properties of the cells at any time point we want...

As I understand, bone marrow transplant is the evolution of what Donald Thomas did 50, 60 years ago. However, the bone marrow transplant so far is very… we use a lot of chemicals, a lot of drugs. So to me, bone marrow transplant evolution is a cell therapy evolution. So this is why graft manipulation allows us to control and to incorporate the properties of the cells at any time point we want. This is different from what we are doing with PTCy, that PTCy is easier, probably could be cheaper, it could be worldwide. However, you are losing the control of what cells can do at any point. So this is why most or some of the pediatric groups, we are dealing with these graft engineering strategies, and we are showing that we can have very, very nice graft-versus-leukemia effect, very, very nice survival, less graft-versus-host disease in most of the cases, and we can improve as well the bone marrow transplant outcome even without any chemical drugs with any PTCy. It’s something not easy. It’s something we have to try to make more simple in order to make accessible for everyone. But I am fully, fully convinced that this is going to be the future to make an evolution of a cell therapy, even that most of the centers right now, they are doing the opposite thing. But, you know, this is something you are not right, you are not wrong. It’s something we have to do more research in the following years.

 

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