Contemporary Updates in the Prevention and Treatment of Graft-Versus-Host Disease.

IF 2.7 3区 医学 Q2 HEMATOLOGY
Current Hematologic Malignancy Reports Pub Date : 2024-12-01 Epub Date: 2024-11-09 DOI:10.1007/s11899-024-00741-y
Sameem Abedin, Mehdi Hamadani
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引用次数: 0

Abstract

Purpose of review: Graft-versus-host disease (GVHD) is a serious complication after allogeneic HCT. Recently, several pivotal studies have been conducted demonstrating significant improvements in the management of GVHD. Here, we review important trials pertaining to GVHD prevention, acute GVHD treatment, and treatment of steroid refractory acute and chronic GVHD.

Recent findings: Clinical trials in preventing GVHD demonstrate lower rates of severe acute GVHD and chronic GVHD with post-transplant cyclophosphamide. For acute GVHD, lower risk acute GVHD appears amenable to steroid-sparing therapies, such as sirolimus and itacitinib. Combinations with novel agents such as itolizumab appear promising for high risk acute GVHD. For steroid-refractory acute GVHD, ruxolitinib should be considered first line therapy. For chronic GVHD requiring therapy beyond steroids, ruxolitinib, belumosudil, and ibrutinib are now available and should be considered. Increasingly, GVHD has become a manageable complication after allogeneic HCT potentially translating to greater success with allogeneic HCT in the future.

预防和治疗移植物抗宿主病的当代最新进展。
综述的目的:移植物抗宿主疾病(GVHD)是异基因造血干细胞移植后的一种严重并发症。最近进行的几项关键性研究表明,GVHD 的治疗有了显著改善。在此,我们回顾了有关 GVHD 预防、急性 GVHD 治疗以及类固醇难治性急性和慢性 GVHD 治疗的重要试验:预防GVHD的临床试验表明,移植后使用环磷酰胺可降低严重急性GVHD和慢性GVHD的发生率。对于急性胶原性肝炎,西罗莫司和伊塔替尼等节省类固醇的疗法似乎适合风险较低的急性胶原性肝炎患者。与伊妥珠单抗等新型药物联合治疗高风险急性GVHD似乎很有前景。对于类固醇难治性急性 GVHD,应将 Ruxolitinib 作为一线疗法。对于需要接受类固醇以外治疗的慢性 GVHD,现在可以考虑使用 Ruxolitinib、belumosudil 和 ibrutinib。GVHD已逐渐成为异基因造血干细胞移植后可控的并发症,这有可能使异基因造血干细胞移植在未来取得更大的成功。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.00
自引率
0.00%
发文量
28
审稿时长
>12 weeks
期刊介绍: his journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hematologic malignancy. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as leukemia, lymphoma, myeloma, and T-cell and other lymphoproliferative malignancies. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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