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Background and Importance Patients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) require complex pharmacotherapeutic regimens for disease treatment and complication prevention. International recommendations, such as those from the European Society for Blood and Marrow Transplantation (EBMT), emphasise the integration of clinical pharmacists into transplant teams to optimise therapy and enhance patient outcomes.Aim and Objectives The primary objective was to explore whether a pharmacist-driven program (PHARALLO) impact on the cumulative incidence of acute graft-versus-host disease (aGVHD) by day +100 post-transplant.Secondary objectives included survival outcomes, incidence of acute renal/liver failure, total and aGVHD-related readmissions, length of hospital stay and time to platelet/neutrophil engraftment by day +100.Material and Methods Prospective, interventional study with a historical control group over a 12-month period, comparing a pharmacist-driven intervention (2024) versus standard care (2022) in patients receiving allo-HSCT. Inclusion criteria: patients ≥18 years undergoing allo-HSCT. Exclusion criteria: lack of informed consent, study withdrawal and death/loss to follow-up before transplantation.The pharmaceutical follow-up consisted of three periods: 1) medication reconciliation in a pre-HSCT-interview), 2) daily review of pharmacotherapy to detect drug-related-problems (DRPs) during hospital stay; and 3) biweekly clinical interviews from discharge until day +100 to reinforce medication knowledge, adherence and detect DRPs.Demographic and clinical data were collected from electronic medical records.aGVHD-cumulative-incidence was compared between groups using Chi-square or Fisher’s exact test. Survival outcomes were analysed with multivariable Cox regression. Other categorical and continuous variables were compared using appropriate parametric/non-parametric tests (Chi-square, Fisher’s exact, Wilcoxon). Statistical analysis was performed by the statistical program STATA; p<0.05 was considered significant.Results 67 patients were included (37 intervention; 30 control).The cumulative incidence of aGVHD by day +100 was reduced by 13.4% in the intervention group (p=0.52). aGVHD-free survival improved by 21.7% (p=0.05). Progression-free and overall survival improved by 9.9% (p=0.31) and 12.6% (p=0.23) respectively. Reductions were observed in acute renal failure (7.8%, p=0.57), liver failure (7.9%, p=0.13) and readmissions (total 10.4%, p=0.1; aGHVD-related 11.3%, p=0.23). Length of hospital stay decreased by 6.3 days (p=0.018). Platelet/neutrophil engraftment occurred 5 days earlier (p=0.022).Conclusion and Relevance The integration of the clinical pharmacist into the TCMH team showed favourable trends towards improved outcomes, reduced complications, shorter hospital stays and faster grafting. These findings suggest the potential value of pharmaceutical care in post-transplant treatment and support the need for further prospective studies.Conflict of Interest No conflict of interest