Joseph Pidala1. 1. Blood and Marrow Transplant Program, Moffitt Cancer Center, Tampa, FL 33612, USA. Joseph.Pidala@moffitt.org
Abstract
BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative therapy with proven efficacy in the management of hematologic malignancies. However, it is complicated by the syndromes of acute and chronic graft-vs-host disease (GVHD). METHODS: A narrative review is provided to summarize major biologic insights into the pathogenesis of these immune-mediated disorders, as well as advances in diagnosis, classification, prevention, management, and allied supportive care with the aim of providing essential understanding for clinicians with or without subspecialty experience in the field of blood and marrow transplantation. RESULTS: Major scientific advances have contributed to enhanced understanding of the pathogenesis of these disorders, and clinical investigation has provided more effective preventive and therapeutic strategies for GVHD. However, since acute GVHD and chronic GVHD remain leading sources of transplantation-related morbidity and mortality, ongoing investigation is needed to develop new approaches to addressing these syndromes. CONCLUSIONS: The major challenge for future investigation will be to capitalize on biologic insights in order to develop novel strategies for the prevention and therapy of acute and chronic GVHD that will address the current shortcomings in existing therapeutic approaches.
BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative therapy with proven efficacy in the management of hematologic malignancies. However, it is complicated by the syndromes of acute and chronic graft-vs-host disease (GVHD). METHODS: A narrative review is provided to summarize major biologic insights into the pathogenesis of these immune-mediated disorders, as well as advances in diagnosis, classification, prevention, management, and allied supportive care with the aim of providing essential understanding for clinicians with or without subspecialty experience in the field of blood and marrow transplantation. RESULTS: Major scientific advances have contributed to enhanced understanding of the pathogenesis of these disorders, and clinical investigation has provided more effective preventive and therapeutic strategies for GVHD. However, since acute GVHD and chronic GVHD remain leading sources of transplantation-related morbidity and mortality, ongoing investigation is needed to develop new approaches to addressing these syndromes. CONCLUSIONS: The major challenge for future investigation will be to capitalize on biologic insights in order to develop novel strategies for the prevention and therapy of acute and chronic GVHD that will address the current shortcomings in existing therapeutic approaches.
Authors: Holly K Miller; Thomas M Braun; Terri Stillwell; Andrew C Harris; Sung Choi; James Connelly; Daniel Couriel; Steven Goldstein; Carrie L Kitko; John Magenau; Attaphol Pawarode; Pavan Reddy; Mary Riwes; Gregory A Yanik; John E Levine Journal: Biol Blood Marrow Transplant Date: 2016-12-22 Impact factor: 5.742
Authors: Steffen T Simon; Anne Pralong; Michael Hallek; Christoph Scheid; Udo Holtick; Marco Herling Journal: Ann Hematol Date: 2021-05-06 Impact factor: 3.673
Authors: Freya Wenzel; Anne Pralong; Udo Holtick; Christoph Scheid; Marco Herling; Steffen T Simon Journal: Cancers (Basel) Date: 2021-05-30 Impact factor: 6.639