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Multidisciplinary management of cGvHD post HSCT
By Ella Dixon
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cGvHD is a complex condition affecting multiple organs, including the skin, liver, lungs, and eyes, leading to significant morbidity and mortality in patients undergoing HSCT.1 A review by Shah et al.1 published in Clinical Hematology International summarized the impact of cGvHD on patients, including those that are not captured in the National Institutes of Health Consensus Criteria. |
| Key learnings |
| cGvHD is a significant cause of mortality in patients post HSCT and the most common cause of NRM. cGvHD causes tissue damage, chronic inflammation, and organ fibrosis, impacting physical and emotional QoL. |
| Traditional management relies heavily on systemic glucocorticoids, but ECP or newer FDA-approved therapies like ibrutinib, ruxolitinib, and belumosudil provide options for patients with steroid-refractory cGvHD, improving outcomes. |
| Long-term use of immunosuppressants contributes to complications like osteoporosis, metabolic syndrome, cardiovascular disease, and endocrine dysfunction, necessitating careful monitoring and management. |
| Effective management of cGvHD requires a comprehensive and multidisciplinary care team approach, including transplant specialists, primary care providers, subspecialists, and allied health professionals to address treatment-related toxicities and to improve outcomes and QoL. |
Abbreviations: cGvHD, chronic graft-versus-host disease; ECP, extracorporeal photopheresis; FDA, U.S. Food and Drug Administration; HSCT, hematopoietic stem cell transplant; NRM, non-relapse mortality; QoL, quality of life.
- Shah R, Murphy D, Logue M, et al. Multidisciplinary management of morbidities associated with chronic graft-versus-host disease. Clin Hematol Int. 2024;6(4):74-88. DOI: 46989/001c.124926
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