How I treat acute graft-versus-host disease of the gastrointestinal tract and the liver.
George B McDonaldPublished in: Blood (2016)
Treatment of acute graft-versus-host disease (GVHD) has evolved from a one-size-fits-all approach to a more nuanced strategy based on predicted outcomes. Lower and time-limited doses of immune suppression for patients predicted to have low-risk GVHD are safe and effective. In more severe GVHD, prolonged exposure to immunosuppressive therapies, failure to achieve tolerance, and inadequate clinical responses are the proximate causes of GVHD-related deaths. This article presents acute GVHD-related scenarios representing, respectively, certainty of diagnosis, multiple causes of symptoms, jaundice, an initial therapy algorithm, secondary therapy, and defining futility of treatment.
Keyphrases
- liver failure
- allogeneic hematopoietic stem cell transplantation
- drug induced
- respiratory failure
- end stage renal disease
- aortic dissection
- newly diagnosed
- machine learning
- ejection fraction
- chronic kidney disease
- acute myeloid leukemia
- climate change
- acute lymphoblastic leukemia
- combination therapy
- hepatitis b virus
- deep learning
- prognostic factors
- mesenchymal stem cells
- bone marrow
- metabolic syndrome
- patient reported
- skeletal muscle
- sleep quality
- smoking cessation
- insulin resistance
- mechanical ventilation