Pharmacogenetics of graft-versus-host disease: a path to personalized medicine.

Graft-versus-host disease (GvHD) remains a significant complication of allogeneic hematopoietic stem cell transplantation (HSCT), contributing to increased morbidity and mortality. Thus, continuous development of novel prophylactic and therapeutic approaches is crucial for GvHD prevention and management. With the current development of personalized medicine and a more patient-oriented approach, pharmacogenetics has the potential to become a critical factor in optimizing the prophylaxis and treatment of GvHD. This review explores the role of pharmacogenetic variants in prophylaxis and management of GvHD, including drugs such as calcineurin inhibitors, methotrexate, mycophenolate mofetil, cyclophosphamide, and corticosteroids. A deeper understanding of these genetic factors could help in developing a more personalized approach to GvHD management, improving clinical outcomes and minimizing adverse effects. This review underscores the need for more pharmacogenetic association studies, as well as for incorporating pharmacogenetic testing into clinical practice to refine drug selection and dosing strategies in GvHD treatment.