NCCN guidelines for allo-HSCT and management of GvHD: Version 3.2025

Graft-versus-host disease (GvHD) is a common complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with increased morbidity. The National Comprehensive Cancer Network (NCCN) guidelines for HSCT provide expert recommendations for the diagnosis and management of acute GvHD (aGvHD) and chronic GvHD (cGvHD). Loren et al. published these recommendations in the Journal of the National Comprehensive Cancer Network.

Key data: The NCCN guidelines provide recommendations for allo-HSCT donor selection, conditioning regimens, and GvHD management, including diagnosis and first-line therapies. The guidelines also recommend systemic agents for steroid-refractory GvHD and emphasize supportive care, including infection prophylaxis and post-transplant monitoring. Effective GvHD management requires a multidisciplinary approach in medical centers with access to specialized transplant services.

Key learning: The NCCN guidelines provide an evidence- and consensus-based approach for HSCT in adult patients with malignancies. Further research is required to enhance risk stratification, develop new therapies for steroid-refractory GvHD, and improve supportive care. Enrollment in clinical trials is strongly encouraged for patients with steroid-refractory aGvHD or cGvHD.