title: Have we improved in preventing and treating acute graft-versus-host disease?
abstract: OBJECTIVE
  Acute graft-versus-host disease (GVHD) is a considerable source of morbidity and mortality following allogeneic hematopoietic cell transplantation (HCT). Accordingly, progress in the prevention and primary therapy of this complication is needed to improve patient outcomes.
  
  
  RESULTS
  Guided by insights into acute GVHD pathogenesis, investigators have explored novel cellular and pharmacologic approaches to acute GVHD prevention that demonstrates promise. Although pan-T-cell depletion has reduced GVHD, novel strategies that selectively deplete alloreactive T cells or modulate the balance of effector T cells and regulatory T cells offer promise to selectively abrogate acute GVHD while retaining protection from primary disease relapse and infectious complications.
  
  
  CONCLUSIONS
  Divergent approaches in the primary therapy of acute GVHD have explored both combination approaches with standard dose glucocorticoids and additional immunosuppressive agents and conversely steroid-sparing approaches including topical agents such as beclomethasone or sirolimus as a steroid-free approach to acute GVHD therapy. Mature results of high-quality clinical trials are needed to determine the optimal therapy that results in effective control of the syndrome and limited toxicity. These complementary outcomes represent the therapeutic goal for future investigation in acute GVHD therapy.
authors.affiliation: Department of Oncological Sciences, University of South Florida, Florida, USA.
authors.forename: Lia
authors.initials: L
authors.lastname: Perez
authors.forename: Claudio
authors.initials: C
authors.lastname: Anasetti
authors.forename: Joseph
authors.initials: J
authors.lastname: Pidala
mesh_terms: D000208:Acute Disease; D006086:Graft vs Host Disease / Q000276:immunology* / Q000517:prevention & control / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D008212:Lymphocyte Depletion / Q000379:methods; D050378:T-Lymphocytes, Regulatory / Q000276:immunology
chemical_list: D007166:Immunosuppressive Agents