Dr Jimenez Jimenez on the Clinical Implications of the ACCESS Trial in Hematological Malignancies

Antonio Martin Jimenez Jimenez, MD, associate professor, medicine, University of Miami Sylvester Comprehensive Cancer Center, discusses the clinical implications of the phase 2 ACCESS study (NCT04904588), which evaluated the use of reduced-intensity conditioning therapy, mobilized peripheral blood stem cells (PBSC) from HLA-mismatched unrelated donors (MMUD), and post-transplant cyclophosphamide (PTCy) for graft-vs-host disease (GVHD) prophylaxis in adult patients with hematological malignancies.

The ACCESS study determined that the success observed with bone marrow grafts could be replicated using PBSC in HLA-mismatched settings. Jimenez Jimenez notes that the trial demonstrated that PBSC transplants from MMUD could be performed safely with effective GVHD prophylaxis using PTCy. This treatment approach broadens the donor pool for this population, offering a viable transplant option to a wider range of patients, regardless of race or ethnicity, he says.

In a presentation given at the 2024 ASCO Annual Meeting, Jimenez Jimenez noted that the ability to perform mismatched and even highly mismatched transplants safely is an important development in ensuring that all patients, irrespective of their racial or ethnic background, have access to potentially life-saving transplant opportunities. The expanded donor pool allows for more specified donor selection, including from younger donors and those without antibodies, thereby optimizing the transplant outcomes, according to Jimenez Jimenez.

Additionally, Jimenez Jimenez explains that the study’s findings underscore the feasibility of selecting donors based on specific criteria, such as blood type and CMV status, further personalizing and enhancing the transplant process. This level of customization is crucial in reducing complications and improving overall survival rates, he emphasizes.

The clinical implications of the ACCESS study are profound, Jimenez Jimenez reports. By demonstrating the safety and efficacy of using PBSC from MMUD with reduced-intensity conditioning and PTCy for GVHD prophylaxis, the study paves the way for more inclusive and optimized transplant options, he says. This advancement ensures safer transplants and enhances the ability to select the best possible donor for each patient, ultimately improving transplant outcomes, Jimenez Jimenez concludes.