Ancillary therapy and supportive care of chronic graft-versus-host disease: national institutes of health consensus development project on criteria for clinical trials in chronic Graft-versus-host disease: V. Ancillary Therapy and Supportive Care Working Group Report.
The Ancillary Therapy and Supportive Care Working Group had 3 goals: (1) to establish guidelines for ancillary therapy and supportive care in chronic graft-versus-host disease (GVHD), including treatment for symptoms and recommendations for patient education, preventive measures, and appropriate follow-up; (2) to provide guidelines for the prevention and management of infections and other common complications of treatment for chronic GVHD; and (3) to highlight the areas with the greatest need for clinical research. The definition of "ancillary therapy and supportive care" embraces the most frequent immunosuppressive or anti-inflammatory interventions used with topical intent and any other interventions directed at organ-specific control of symptoms or complications resulting from GVHD and its therapy. Also included in the definition are educational, preventive, and psychosocial interventions with this same objective. Recommendations are organized according to the strength and quality of evidence supporting them and cover the most commonly involved organs, including the skin, mouth, female genital tract, eyes, gastrointestinal tract, and lungs. Recommendations are provided for prevention of infections, osteoporosis, and steroid myopathy and management of neurocognitive and psychosocial adverse effects related to chronic GVHD. Optimal care of patients with chronic GVHD often requires a multidisciplinary approach.
Couriel
Daniel
D
University of Texas MD Anderson Cancer Center, Houston, 77030, USA. dcouriel@mdanderson.org
Carpenter
Paul A
PA
Cutler
Corey
C
Bolaños-Meade
Javier
J
Treister
Nathaniel S
NS
Gea-Banacloche
Juan
J
Shaughnessy
Paul
P
Hymes
Sharon
S
Kim
Stella
S
Wayne
Alan S
AS
Chien
Jason W
JW
Neumann
Joyce
J
Mitchell
Sandra
S
Syrjala
Karen
K
Moravec
Carina K
CK
Abramovitz
Linda
L
Liebermann
Jerry
J
Berger
Ann
A
Gerber
Lynn
L
Schubert
Mary
M
Filipovich
Alexandra H
AH
Weisdorf
Daniel
D
Schubert
Mark M
MM
Shulman
Howard
H
Schultz
Kirk
K
Mittelman
Barbara
B
Pavletic
Steven
S
Vogelsang
Georgia B
GB
Martin
Paul J
PJ
Lee
Stephanie J
SJ
Flowers
Mary E D
ME
D000720:Ancillary Services, Hospital; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications / Q000523:psychology / Q000628:therapy; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D010353:Patient Education as Topic / Q000379:methods