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Graft-versus-host disease (GvHD) is a common and severe complication observed after allogenic hematopoietic stem cell transplant (allo-HSCT).1 GvHD can be acute (aGvHD) or chronic (cGvHD) depending on the onset and clinical manifestations.2 First-line treatment is based on corticosteroids, but prolonged use is associated with toxicities and development of resistance. Currently, there are only two approved treatments for GvHD: ruxolitinib, indicated for steroid resistant (SR) aGvHD, and ibrutinib, used in patients with cGvHD who have failed one or more lines of therapy. There is currently a strong unmet need for new GvHD treatment options, and many emerging treatments are being tested.
We have reported on the EBMT–ELN working group recommendations for the treatment of aGvHD that were presented at the 1st EBMT GvHD Summit in May 2019. These guidelines have been developed to improve the outcomes of patients with GvHD and are based on the current standard of practice in European hematology centers. Recently, an update of these guidelines has been published in Lancet Haematology.3
The new GvHD Hub editorial theme will focus on novel therapies for the treatment of GvHD. Here are some highlights of the content that the GvHD Hub has previously covered on novel therapies.
Adoptive cell therapy:
At the 24th Congress of the European Hematology Association (EHA), Florent Malard, Hospital Saint-Antoine, Paris, FR, talked to the GvHD Hub about the use of fecal microbiota transplantation in the context of GvHD treatment
Florent Malard | EHA 2019 | How can we better utilize FMT in patients undergoing stem cell transplantation?
Madan Jagasia | ASH 2019 | Is sustained treatment with KD025 required for cGvHD control?
Over the last 15 years, the field of cGvHD has evolved, with the development of novel treatments that are more effective and less toxic. At the 61st ASH Annual Meeting, Steven Pavletic talked about ongoing clinical trials and new drugs for the treatment of cGvHD, such as JAK inhibitors and ROCK inhibitors.
Steven Pavletic | ASH 2019 | What is new in chronic GvHD?
EBMT GvHD Summit 2019 | Treatment of acute GvHD based on the EBMT–ELN working group recommendations
Corticosteroids are the accepted first-line treatment for aGvHD, however other treatments are sought due to steroid resistance or steroid dependence...
Management of patients with steroid-refractory acute graft-versus-host disease – treatment options and unmet clinical need
A review evaluating both current and emerging treatment and management options for patients with steroid-refractory aGvHD
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