Visual abstract | Vitamin A for the prevention of GvHD in pediatric patients undergoing allo-HSCT

The GvHD Hub is happy to present a visual abstract summarizing key findings from a prospective, double-blind trial evaluating the efficacy of high-dose vitamin A for graft-versus-host disease (GvHD) in pediatric patients undergoing an allogeneic hematopoietic stem cell transplant, as presented during the 2023 Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR.

Baseline patient characteristics are shown in Table 1. Despite a higher proportion of patients in the vitamin A cohort having characteristics that predispose them to GvHD (HLA mismatching, donor relation, and the use of unmanipulated peripheral blood stem cells), patients in the vitamin A cohort had a lower incidence of GvHD.¹

Table 1. Baseline patient characteristics*

The use of high-dose vitamin A is already recommended by the World Health Organization (WHO) for treatment of children with acute measles.¹ Vitamin A is involved in gut homeostasis by maintaining barrier function and expression of junction proteins in the intestinal epithelium. The level of CCR9⁺ CD8⁺ effector memory T-cells were significantly higher in the placebo arm at Day 30 posttransplant compared with the vitamin A arm; therefore, this shows that gut T-cell trafficking was reduced in patients treated with vitamin A (p = 0.01).¹