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This is a combination regimen of three drugs—cyclophosphamide, bortezomib, and abatacept—used primarily for the prevention of graft-versus-host disease (GvHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cyclophosphamide is an alkylating agent that suppresses immune responses by cross-linking DNA. Bortezomib is a proteasome inhibitor that disrupts protein degradation pathways in cells, leading to apoptosis of activated immune cells. Abatacept is a selective co-stimulation modulator that inhibits T-cell activation by binding to CD80/CD86 on antigen-presenting cells and preventing their interaction with CD28 on T-cells. This combination aims to reduce the incidence and severity of both acute and chronic GvHD while maintaining engraftment and minimizing relapse risk in patients with hematologic malignancies undergoing allo-HSCT[1][2][8].
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