Acute Graft-versus-Host Disease: An Update on New Treatment Options.
Dilan A PatelMallory CrainIskra PusicMark G FrattiniPublished in: Drugs (2023)
Acute graft-versus-host disease (GVHD) occurs in approximately 50% of patients and remains a primary driver of non-relapse and transplant-related mortality. The best treatment remains prevention with either in vivo or ex vivo T-cell depletion, with multiple strategies used worldwide based on factors such as institution preference, ability to perform graft manipulation, and ongoing clinical trials. Predicting patients at high risk for developing severe acute GVHD based on clinical and biomarker-based criteria allows for escalation or potential de-escalation of therapy. Modern therapies for treatment of the disease include JAK/STAT pathway inhibitors, which are standard of care in the second-line setting and are being investigated for upfront management of non-severe risk based on biomarkers. Salvage therapies beyond the second-line remain suboptimal. In this review, we will focus on the most clinically used GVHD prevention and treatment strategies, including the accumulating data on JAK inhibitors in both settings.
Keyphrases
- end stage renal disease
- clinical trial
- newly diagnosed
- chronic kidney disease
- liver failure
- ejection fraction
- prognostic factors
- healthcare
- stem cells
- respiratory failure
- type diabetes
- early onset
- patient reported outcomes
- open label
- coronary artery disease
- acute lymphoblastic leukemia
- cardiovascular disease
- combination therapy
- climate change
- mesenchymal stem cells
- free survival
- pain management
- risk assessment
- acute respiratory distress syndrome
- patient reported
- phase ii
- mechanical ventilation
- aortic dissection
- smoking cessation
- affordable care act