New molecules in the therapy of chronic graft-versus-host disease.

IF 2.9 3区 医学 Q2 HEMATOLOGY
Laurenz Steiner, Stefan A Klein, Sebastian Kreil
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引用次数: 0

Abstract

Purpose of review: Chronic graft-versus-host disease (cGvHD) remains a major complication following allogeneic hematopoietic cell transplantation, frequently requiring multiple lines of immunosuppressive treatment. The increasing approval of targeted therapies demands an updated understanding of their clinical positioning, strengths, and safety considerations.

Recent findings: Several agents have been approved for cGvHD following treatment failure, including ibrutinib and ruxolitinib after first line, and belumosudil and axatilimab after at least two prior therapies. Novel compounds such as ivarmacitinib, TDI-01, rovadicitinib, and pimicotinib target distinct or combined inflammatory and fibrotic pathways and demonstrate promising efficacy across multiple organ systems. However, safety profiles and organ-specific response rates vary. Prior exposure to Janus kinase inhibitors influences therapeutic sequencing, while discrepancies between formal and patient-reported outcomes represent challenges for data interpretation.

Summary: Expanding therapeutic options in cGvHD require decision-making based on organ involvement, prior therapy, and tolerability. Emerging compounds offer the potential to modulate chronic inflammation and fibrosis more precisely, supporting a move toward personalized and combinatorial approaches in advanced-line settings.

治疗慢性移植物抗宿主病的新分子。
综述目的:慢性移植物抗宿主病(cGvHD)仍然是同种异体造血细胞移植后的主要并发症,通常需要多种免疫抑制治疗。靶向治疗的批准越来越多,需要对其临床定位、优势和安全性考虑进行更新的理解。最近的发现:一些药物在治疗失败后被批准用于治疗cGvHD,包括伊鲁替尼和鲁索利替尼在一线治疗后,以及贝莫舒地尔和阿塞利单抗在至少两次治疗后。新型化合物如伊瓦马替尼、TDI-01、罗伐地替尼和吡米可替尼靶向不同的或联合的炎症和纤维化途径,并在多器官系统中显示出有希望的疗效。然而,安全性和器官特异性反应率各不相同。先前暴露于Janus激酶抑制剂会影响治疗测序,而正式结果和患者报告结果之间的差异对数据解释提出了挑战。总结:扩大cGvHD的治疗选择需要根据器官受累、既往治疗和耐受性做出决策。新兴化合物提供了更精确地调节慢性炎症和纤维化的潜力,支持在晚期环境中向个性化和组合方法的转变。
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
6.60
自引率
3.10%
发文量
78
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​Current Opinion in Hematology is an easy-to-digest bimonthly journal covering the most interesting and important advances in the field of hematology. Its hand-picked selection of editors ensure the highest quality selection of unbiased review articles on themes from nine key subject areas, including myeloid biology, Vascular biology, hematopoiesis and erythroid system and its diseases.
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