Treatment and management of graft-versus-host disease: improving response and survival
Open Access
- 31 May 2013
- journal article
- review article
- Published by SAGE Publications in Therapeutic Advances in Hematology
- Vol. 4 (6), 366-378
- https://doi.org/10.1177/2040620713489842
Abstract
Graft-versus-host disease (GVHD) is a significant cause of morbidity and mortality following allogenic haematopoietic stem-cell transplantation and thus the focus of much ongoing research. Despite considerable advances in our understanding of the pathophysiology, diagnosis and predisposing factors for both acute and chronic forms of the disease, a standardised therapeutic strategy is still lacking. There is good evidence for initial treatment of both acute and chronic forms of the disease with corticosteroid therapy. However, the most effective approach to steroid-refractory disease remains controversial, with current practice based mainly on smaller studies and varying considerably between local institutions. Timely diagnosis, multidisciplinary working and good supportive care, including infection prophylaxis, are clearly important in optimizing response and survival in such patients. It is hoped that in the future systematic research strategies and the identification of novel therapeutic targets may improve outcome further. The following review aims to outline some of the existing options for the treatment and management of acute and chronic GVHD.Keywords
This publication has 78 references indexed in Scilit:
- A Multi-Center, Randomized, Double Blind, Phase III Clinical Trial Comparing Steroids/Placebo Vs. Steroids/Mycophenolate Mofetil As Initial Therapy for Acute Graft-Versus-Host Disease. Blood and Marrow Transplant Clinical Trials Network Study 0802Transplantation and Cellular Therapy, 2013
- Blockade of Lymphocyte Chemotaxis in Visceral Graft-versus-Host DiseaseThe New England Journal of Medicine, 2012
- Novel treatment concepts for graft-versus-host diseaseBlood, 2012
- Patient-reported quality of life is associated with severity of chronic graft-versus-host disease as measured by NIH criteria: report on baseline data from the Chronic GVHD ConsortiumBlood, 2011
- Comparative analysis of risk factors for acute graft-versus-host disease and for chronic graft-versus-host disease according to National Institutes of Health consensus criteriaBlood, 2011
- Etanercept, mycophenolate, denileukin, or pentostatin plus corticosteroids for acute graft-versus-host disease: a randomized phase 2 trial from the Blood and Marrow Transplant Clinical Trials NetworkBlood, 2009
- Evaluation of mycophenolate mofetil for initial treatment of chronic graft-versus-host diseaseBlood, 2009
- Graft-versus-host diseaseThe Lancet, 2009
- Therapy with mycophenolate mofetil for refractory acute and chronic GVHDBone Marrow Transplantation, 2009
- Initial therapy of acute graft-versus-host disease with low-dose prednisone does not compromise patient outcomesBlood, 2009