American Journal of Hematology最新文献

{"title":"Frontline Therapy of AML in the Fit and Younger Population—Incorporating Molecularly Targeted Agents","authors":"Keith W. Pratz,&nbsp;Harry P. Erba","doi":"10.1002/ajh.27585","DOIUrl":"https://doi.org/10.1002/ajh.27585","url":null,"abstract":"<p>Backbone therapy for acute myeloid leukemia for younger adults has for 50 years been based on a combination of cytarabine and anthracycline. Over the past 10 years the addition of several targeted agents has been found to improve the outcomes of subsets of AML with particular molecular changes. In this review we will examine the data generated to date on the addition of agents targeting CD33, FLT3, IDH, and BCL2 to standard high intensity therapies. We will also review the potential for future studies evaluating the application of highly active lower intensity therapies developed in older adults to patients considered “fit for high intensity induction.” Lastly, we review the data around the role of stem cell transplant in the modern targeted era.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 S2","pages":"16-22"},"PeriodicalIF":10.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27585","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maintenance Therapy in AML: What Is the Future Potential?","authors":"Hannah Goulart,&nbsp;Andrew H. Wei,&nbsp;Tapan M. Kadia","doi":"10.1002/ajh.27583","DOIUrl":"https://doi.org/10.1002/ajh.27583","url":null,"abstract":"<p>Over the last decade, there have been significant advancements in the treatment for patients with acute myeloid leukemia (AML) including the addition of novel, targeted agents to intensive or nonintensive chemotherapy regimens. However, despite this, the majority of patients will still ultimately relapse and long-term survival remains poor. While the use of maintenance therapy has emerged as a potential strategy to maintain more durable remissions and improve overall survival, the optimal use of these therapies has not yet been clearly defined. In this review, we provide a comprehensive overview of the evolution of maintenance strategies in AML and present a commentary on the future of maintenance therapy, including the pressing, unmet needs in this field.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 S2","pages":"38-49"},"PeriodicalIF":10.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27583","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Advances and Future of Therapy in Acute Myeloid Leukemia","authors":"Farhad Ravandi","doi":"10.1002/ajh.27617","DOIUrl":"https://doi.org/10.1002/ajh.27617","url":null,"abstract":"&lt;p&gt;Significant progress in the characterization of molecular pathogenic events in acute myeloid leukemia (AML) has led to better characterization of prognosis and identification of subsets that are more likely to benefit from currently available strategies. Furthermore, deciphering these molecular pathogenic events has led to the development of a number of effective molecularly targeted agents that have significantly improved our armamentarium in managing patients with AML. This has certainly provided us with opportunities for improving outcomes but at the same time has created new challenges for satisfactory patient management.&lt;/p&gt;&lt;p&gt;Better characterization of cytogenetic and molecular subsets serves to provide long-term prognostic information but also necessitates rapid identification of subsets that may be amenable to specific therapeutic interventions. Furthermore, gaining deeper insights into the biology of disease may increase the emphasis on these pathogenic biologic events rather than morphology for disease characterization. For example, blurring the boundaries of AML and myelodysplastic syndrome (MDS), and relying more on molecular rather than morphological features for disease characterization.&lt;/p&gt;&lt;p&gt;Although cytotoxic chemotherapy such as cytarabine and anthracyclines remain the mainstay of therapeutic regimens in AML particularly in the younger and fitter patients who are able to tolerate them, the introduction of venetoclax-based regimens has revolutionized the management of older patients with AML who constitute the vast majority of the patients. This has improved the outcomes of less fit, older patients significantly, but long-term follow-up has demonstrated that such benefit has not been universal and is also very much dependent on the molecular characteristics of the disease. Further incorporation of targeted agents in such backbones has been attempted in several subsets of AML such as &lt;i&gt;FLT3&lt;/i&gt; mutated, &lt;i&gt;IDH&lt;/i&gt; mutated and &lt;i&gt;KMT2A&lt;/i&gt; rearranged AML with significant success, yet generating the debate about whether a concomitant or sequential administration of these agents is the best strategy. Conventional wisdom that led to the development of multiagent regimens in cancer therapy suggests that the former rather than the latter would be the more effective strategy that would prevent the development of resistance and thereby would provide a more sustained response translating to longer survival and potential cure. Of course, the challenge will remain how to best develop such combinations so that the benefits are not offset by any potential toxicities. The recent development and availability of oral formulations of hypomethylating agents has allowed the development of fully oral regimens that clearly can improve the convenience of administration and adherence to therapy. Such oral regimens are not without their challenges and toxicities and their general applicability will require further assessment in ongoing clinical trial","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 S2","pages":"3-4"},"PeriodicalIF":10.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Relapsed/Refractory AML—Novel Treatment Options Including Immunotherapy","authors":"Catherine Gutierrez Moore,&nbsp;Anthony Stein,&nbsp;Amir T. Fathi,&nbsp;Vinod Pullarkat","doi":"10.1002/ajh.27584","DOIUrl":"https://doi.org/10.1002/ajh.27584","url":null,"abstract":"<p>Acute myeloid leukemia is a molecularly heterogenous disease caused by the rapid expansion and impaired differentiation of malignant myeloid progenitors. Overall, outcomes remain poor, and more than half of patients develop relapsed or refractory disease after front-line therapy. Allogeneic hematopoietic stem cell transplant (HCT) remains the best chance for cure for eligible patients, and the development of novel therapies including BCL2, FLT3, IDH1/2 and menin inhibitors, which are efficacious yet generally more tolerable, have enabled better bridging to prompt HCT. Despite the early success of targeted therapies, more generalized and efficacious therapeutic approaches remain in need, and numerous targeted immunotherapeutic agents (including CAR-T, bispecific and trispecific antibody therapies) are currently under investigation.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 S2","pages":"23-37"},"PeriodicalIF":10.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27584","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving the Therapeutic Needle in Immunoglobulin Light Chain and TTR Cardiac Amyloidosis","authors":"Morie A. Gertz","doi":"10.1002/ajh.27642","DOIUrl":"10.1002/ajh.27642","url":null,"abstract":"<p>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 5","pages":"900-902"},"PeriodicalIF":10.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27642","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impairment of Innate Immunity and Depletion of Vaccine-Induced Memory B and T Cells in the Absence of the Spleen","authors":"Veronica Bordoni,&nbsp;Bianca Laura Cinicola,&nbsp;Eva Piano Mortari,&nbsp;Concetta Castilletti,&nbsp;Federica Guarracino,&nbsp;Christian Albano,&nbsp;Silvia Accordini,&nbsp;Anwar Baban,&nbsp;Antonio Di Sabatino,&nbsp;Carlo Maria Rossi,&nbsp;Marco Vincenzo Lenti,&nbsp;Anna Maria Zicari,&nbsp;Riccardo Cirelli,&nbsp;Marco Spada,&nbsp;Gian Luca Forni,&nbsp;Isabella Quinti,&nbsp;Mattia Algeri,&nbsp;Maddalena Casale,&nbsp;Silverio Perrotta,&nbsp;Franco Locatelli,&nbsp;Chiara Agrati,&nbsp;Rita Carsetti","doi":"10.1002/ajh.27634","DOIUrl":"10.1002/ajh.27634","url":null,"abstract":"<p>Splenectomy or congenital asplenia is associated with severe reduction of memory B cells and increased risk of fulminant sepsis by encapsulated bacteria. Current guidelines recommend vaccinations against these pathogens before or after splenectomy, but the longevity of immunity acquired after splenectomy has not been determined. The impact of splenectomy on innate immune cells is unknown. We analyzed frequency, differentiation stage, and function of innate and adaptive immunity in the peripheral blood of adult (<i>n</i> = 41) and pediatric (<i>n</i> = 14) patients splenectomized or born asplenic and in spleens of solid organ donors. The absence of the spleen impacts the B-cell compartment, causing a significant increase of circulating immature transitional and depletion of memory B cells. Using SARS-CoV-2 vaccination as a model, we show that 1 year after the last immunization, despite normal levels of neutralizing antibodies, memory B and T cells were significantly reduced. Analysis of post-pandemic spleens shows that spike-specific memory B and T cells homed to the spleen. We also show a previously unrecognized role of the spleen in the homeostasis of innate NK and Vδ2 T cells. These populations showed altered phenotype and impaired function in the adults, but not in children, suggesting that other tissues may support innate cell development during early life. The reduced function of innate lymphocytes must be considered as an additional immune impairment and risk factor. These findings emphasize the spleen's irreplaceable role in maintaining immune memory across all ages and suggest that its absence contributes to dysfunctions of innate and adaptive immunity in adults.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 5","pages":"770-784"},"PeriodicalIF":10.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27634","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Cerebral Myeloid Sarcoma in an Allogeneic Stem Cell Transplant Recipient","authors":"Gabriele Magliano,&nbsp;Silvia Zanon,&nbsp;Rachele de Domenico,&nbsp;Marco Galli,&nbsp;Enrico Morello,&nbsp;Luisa Lorenzi,&nbsp;Gaetano Paolino,&nbsp;Marco Fontanella,&nbsp;Luciano Buttolo,&nbsp;Diego Bertoli,&nbsp;Giorgio Biasiotto,&nbsp;Michele Malagola,&nbsp;Riccardo Marnoni,&nbsp;Mirko Farina,&nbsp;Vera Radici,&nbsp;Simona Bernardi,&nbsp;Alessandro Leoni,&nbsp;Domenico Russo,&nbsp;Daniele Avenoso","doi":"10.1002/ajh.27640","DOIUrl":"10.1002/ajh.27640","url":null,"abstract":"&lt;p&gt;Late relapse of acute myeloid leukemia (AML) is the main reason for treatment failure after a successful allogeneic hematopoietic stem cell transplant (allo-HSCT). A rare manifestation of disease reoccurrence is isolated myeloid sarcoma. A 67-year-old gentleman underwent allo-HSCT in 2020 after achieving second complete remission, following salvage treatment for relapsed AML originally diagnosed in 2018. At the onset, the cytogenetic assay on bone marrow was remarkable for translocation (16;17)(p11;p13); retrospective next-generation sequencing revealed an acquired mutation in RUNX1, ASXL1, SRSF2, and DNMT3A.&lt;/p&gt;&lt;p&gt;In October 2024, the patient attended our clinic for the onset of a nuchal headache and mild visual disturbances, prompting extensive diagnostic investigations. Magnetic resonance imaging of the central nervous system (CNS) showed the presence of an intra-axial expansive lesion in the right parietal–temporal lobe (maximum orthogonal diameters were 3.4 × 3.1 cm in T2W—Figure 1A and in T1W sequence—Figure 1B). Histopathological analysis revealed the presence of immature cells (Figure 1C) with partial expression of CD34, MPO, CD117, CD4, and CD163, along with negative staining for CD3, CD20, CD19, and CD1a. Nuclear NPM expression was normal. These findings led to the diagnosis of isolated cerebral myeloid sarcoma. Molecular evaluation of the brain biopsy showed the presence of RUNX1, ASXL1, SRSF2, previously detected at the diagnosis. This finding allowed us to rule out a donor-derived myeloid neoplasia. Furthermore, the NGS evaluation was negative for any targetable lesion such as FLT3-ITD, IDH1, or IDH2 but remarkable for new mutations such as STAG2, BCOR, and NRAS, suggesting a clonal evolution of the original disease. Notably, bone marrow biopsy and aspirate confirmed the absence of systemic disease, and chimerism analysis showed 100% donor origin within the CD34+ and CD3 fractions, suggesting that an effective immunological pressure for 4 years was likely the reason for a relapse within a sanctuary organ. Intravenous chemotherapy with cytosine arabinoside (3 g/m&lt;sup&gt;2&lt;/sup&gt;) was administered with minimal clinical response. The patient rapidly developed pancytopenia and faced a septic shock due to multi-susceptible \u0000 &lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt;\u0000 (which prevented an association with radiotherapy). He died after 5 days because of multi-organ failure.&lt;/p&gt;&lt;p&gt;This case underscores the critical importance of a multidisciplinary approach in allo-HSCT recipients, considering the complex interaction between donor immune cells and recipient leukemia cells. It also highlights the necessity of invasive diagnostic procedures for precise disease characterization, which is pivotal for guiding therapeutic strategies and determining prognosis.&lt;/p&gt;&lt;p&gt;Patient provided written consent to collect data for publication. The manuscript was approved by the internal board of the institution.&lt;/p&gt;&lt;p&gt;The authors declare no conflicts of","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 4","pages":"695-696"},"PeriodicalIF":10.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27640","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CSF3R Mutations in Hematological Disorders Undergoing Allogeneic Hematopoietic Stem Cell Transplantation","authors":"Jiaxin Cao,&nbsp;Yawei Zheng,&nbsp;Ruixin Li,&nbsp;Dan Feng,&nbsp;Xiaofei Ni,&nbsp;Hongye Gao,&nbsp;Mingyang Wang,&nbsp;Yigen Cao,&nbsp;Weihua Zhai,&nbsp;Rongli Zhang,&nbsp;Donglin Yang,&nbsp;Yi He,&nbsp;Sizhou Feng,&nbsp;Mingzhe Han,&nbsp;Haixiao Zhang,&nbsp;Aiming Pang,&nbsp;Erlie Jiang","doi":"10.1002/ajh.27643","DOIUrl":"10.1002/ajh.27643","url":null,"abstract":"&lt;p&gt;Colony-stimulating factor 3 receptor gene (&lt;i&gt;CSF3R&lt;/i&gt;) encodes the receptor for granulocyte-colony stimulating factor, regulating the activation, proliferation, differentiation, and survival of neutrophils [&lt;span&gt;1&lt;/span&gt;]. &lt;i&gt;CSF3R&lt;/i&gt; mutations are commonly found in patients with chronic neutrophilic leukemia (CNL), atypical chronic myeloid leukemia (CML) and chronic myelomonocytic leukemia (CMML), and have also been detected in acute leukemias. The incidence of &lt;i&gt;CSF3R&lt;/i&gt; mutations is about 2.75% in acute myeloid leukemia (AML) patients in China [&lt;span&gt;2&lt;/span&gt;]. In previous studies primarily based on chemotherapy, &lt;i&gt;CSF3R&lt;/i&gt; mutations in AML have been associated with a lower relapse-free survival (RFS) [&lt;span&gt;3&lt;/span&gt;]. Moreover, &lt;i&gt;CSF3R&lt;/i&gt; mutations appear to modulate the protective effect of &lt;i&gt;CEBPα&lt;/i&gt; mutations on the prognosis of AML [&lt;span&gt;4, 5&lt;/span&gt;]. However, the impact of &lt;i&gt;CSF3R&lt;/i&gt; mutations on AML patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains uncertain. Our study aims to shed light on this.&lt;/p&gt;&lt;p&gt;In this correspondence, we retrospectively report the &lt;i&gt;CSF3R&lt;/i&gt; mutation status in 2478 patients with hematological malignancies who underwent allo-HSCT at the HSCT Center of the Blood Diseases Hospital, Chinese Academy of Medical Sciences (CAMS), and focused on &lt;i&gt;de novo&lt;/i&gt; AML patients for prognostic analysis. Genomic mutation status was determined by next-generation sequencing. A 1:2 propensity score matching was conducted to identify control AML patients without &lt;i&gt;CSF3R&lt;/i&gt; mutations who underwent allo-HSCT during the same period. Baseline variables including age, transplantation type, minimal residual disease (MRD) status at HSCT, 2022 ELN genetic risk system, and &lt;i&gt;CEBPα bZIP&lt;/i&gt; mutation were incorporated into the propensity score model. The Kaplan–Meier method was utilized to determine 3-year overall survival (OS) and RFS, with differences tested using log-rank statistics. The relapse risk (RR) was calculated using competing risk analysis, taking into account the competing risks for death. The median follow-up time was 3.1 years. Univariate and multivariate analyses were performed using Cox regression. &lt;i&gt;T&lt;/i&gt; test and Mann–Whitney test were applied to continuous variables and &lt;i&gt;χ&lt;/i&gt;\u0000 &lt;sup&gt;2&lt;/sup&gt; test or Fisher exact test was used for categorical variables. Data analysis was conducted using R 4.2.0. Negative MRD was defined as having less than 0.1% blasts.&lt;/p&gt;&lt;p&gt;Among the patients who underwent allo-HSCT, 72 were identified as positive for &lt;i&gt;CSF3R&lt;/i&gt; mutations (Figure S1). The most common primary disease was AML (32/72, 44.44%), including 28 &lt;i&gt;de novo&lt;/i&gt; AML and 4 secondary AML. Other diseases primarily comprised myelodysplastic syndromes/myeloproliferative neoplasms (MDS/MPN) (20/72, 26.39%), acute lymphoblastic leukemia (ALL) (12/72, 16.67%) and CML (4/72, 5.56%) (Figure S2). The most commonly detected mutations in AML were T618I (9/32, 25.13%) ","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 5","pages":"925-927"},"PeriodicalIF":10.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27643","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Pediatric-Inspired Regimens vs. Hyper-CVAD in the Treatment of Adolescents and Young Adults With Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis","authors":"Wenqing Su,&nbsp;Melisa Stricherz,&nbsp;Alison Martin,&nbsp;Jonathan Belsey,&nbsp;Eric Kemadjou,&nbsp;Daniel J. DeAngelo","doi":"10.1002/ajh.27607","DOIUrl":"10.1002/ajh.27607","url":null,"abstract":"<p>Adults with acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LBL) have poorer outcomes than pediatric patients. The aim of this systematic literature review and meta-analysis was to compare asparaginase (ASP)-containing pediatric-inspired regimens (PIRs) with hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) in adolescents and young adults (AYAs) with ALL/LBL. Searches included relevant publications up to April 21, 2022. A meta-analysis was conducted in four studies with comparable demographics, to estimate the effects of intervention on rates of response and survival. Patients receiving PIRs were approximately twice as likely to achieve complete response and 1.8 times more likely to survive than patients receiving hyper-CVAD. These results suggest ASP-containing PIRs are associated with improved outcomes in AYAs compared with hyper-CVAD.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 5","pages":"847-859"},"PeriodicalIF":10.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27607","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Improving Initial Therapy of Acute Graft Versus Host Disease","authors":"Ansh Krishnachandra Mehta,&nbsp;John Koreth","doi":"10.1002/ajh.27593","DOIUrl":"10.1002/ajh.27593","url":null,"abstract":"<div>\u0000 \u0000 <p>Acute graft versus host disease (aGVHD) is a major complication of hematopoietic stem cell transplantation; it results from donor-derived immune response against host tissues and typically involves the liver, skin and the GI tract. The incidence of acute GVHD is declining due to the advances in HLA typing, reduced intensity conditioning and GVHD prophylaxis. However, corticosteroids remain the mainstay frontline treatment of aGVHD for many decades and as the number of allogeneic transplants continues to increase, there remains a large unmet need to improve frontline treatment for aGVHD. In this review, we outline risk factors, epidemiology and pathogenesis of aGVHD. We discuss the evolving risk stratification, beginning from the initial Gluckesberg system to more recent biomarker-based strategies. We summarize the completed trials that underpin current frontline management and outline future directions.</p>\u0000 </div>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 S3","pages":"40-54"},"PeriodicalIF":10.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27593","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143393557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}