After providing written informed consent, you will be enrolled in the REDUCy study for patients with hematological malignancies (blood cancers) who need a haploidentical hematopoietic stem cell transplantation (a transplant using stem cells from a partially matched family donor).

You will be randomly assigned to receive either the standard dose of post-transplant cyclophosphamide (100 mg/kg) or the reduced dose (70 mg/kg). Cyclophosphamide is a medication that helps prevent rejection of the transplant.

Before the transplant procedure, your medical team will conduct baseline assessments including quality of life questionnaires (FACT-BMT and EQ-5D-5L) to compare with future measurements.

You will receive a thiotepa-based conditioning regimen. This is a combination of medications that prepare your body for the stem cell transplant by clearing space in your bone marrow for the new cells.

You will receive peripheral blood stem cells (PBSC) from your haploidentical donor (a family member who is a partial match).

This procedure is similar to receiving a blood transfusion and is typically not painful.

After the transplantation, you will receive cyclophosphamide according to your assigned group:

– Standard dose group: You will receive a total of 100 mg/kg of cyclophosphamide

– Reduced dose group: You will receive a total of 70 mg/kg of cyclophosphamide

This medication helps prevent graft-versus-host disease (GVHD), a condition where the donated cells attack your body’s tissues.

Your medical team will monitor your recovery, particularly looking at neutrophil recovery (when your white blood cell count returns to safer levels) and platelet recovery (when your platelet count returns to safer levels).

They will also monitor for any signs of infection (bacterial, viral, or fungal) or organ damage.

You will have regular follow-up assessments for two years after your transplant, including:

– Quality of life assessments at 1, 3, 6, 12, and 24 months using questionnaires

– Monitoring for acute GVHD (occurs within the first 180 days after transplant)

– Monitoring for chronic GVHD (can occur up to 2 years after transplant)

– Checking for signs of relapse or progression of your original blood cancer

– Assessment of any side effects from the cyclophosphamide treatment

At the two-year mark after your transplant, the research team will conduct a final assessment to evaluate the GREFS (GVHD-free, relapse-free, event-free survival).

This is a combined measure that looks at whether you have survived without experiencing severe GVHD, cancer relapse, or serious side effects from the cyclophosphamide.