Prophylaxis and treatment of acute graft-versus-host disease.
Acute graft-versus-host disease (GVHD) remains a major obstacle to successful allogeneic hematopoietic stem cell transplantation (HSCT). The ability to prevent GVHD--the application of successful prophylaxis--is crucial as treatment when prophylaxis fails or remains suboptimal. A calcineurin inhibitor in combination with methotrexate is still the mainstream regimen for prophylaxis of GVHD. Despite a steady increase in the repertoire of available drugs, corticosteroids remain the first-line therapy for patients who fail prevention and develop GVHD. Pan T-cell depletion studies suggest that success in prophylaxis and treatment of GVHD will depend on whether GVHD can be prevented without losing anti-malignancy and anti-infectious effects. Better understanding of the allogeneic response that is responsible for GVHD will facilitate the development of such an approach.
Chao
Nelson J
NJ
Division of Cellular Therapy/Bone Marrow Transplantation, Department of Medicine and Immunology, Duke University Medical Center, Durham, NC 27705, USA. chao0002@mc.duke.edu
Chen
Benny J
BJ
D000208:Acute Disease; D006086:Graft vs Host Disease / Q000276:immunology* / Q000517:prevention & control / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans