title: Recent advances in the management of graft-versus-host disease.
abstract: Graft-versus-host disease (GvHD) remains a significant hurdle in overcoming the morbidity and mortality associated with haemopoietic stem cell transplantation in children. Better understanding of its pathobiology is facilitating the development of biomarkers for the severity of acute GvHD and treatment response, and has led to the introduction of a more prognostically relevant grading system for chronic GvHD. These enable stratification of appropriate prophylactic and treatment strategies according to the risk profiles of individual patients. Steroid-refractory acute GvHD has a poor prognosis, but early reports of the use of new immunosuppressive drugs and especially cellular treatments with extracorporeal photopheresis and mesenchymal stem cells suggest improved short-term outcomes and offer the promise of increased longer-term survival rates.
authors.affiliation: Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital, Newcastle upon Tyne, UK.
authors.forename: S
authors.initials: S
authors.lastname: Dhir
authors.affiliation: Children's Haemopoietic Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle upon Tyne, UK.
authors.forename: M
authors.initials: M
authors.lastname: Slatter
authors.affiliation: Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital, Newcastle upon Tyne, UK Children's Haemopoietic Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle upon Tyne, UK.
authors.forename: R
authors.initials: R
authors.lastname: Skinner
mesh_terms: D015415:Biomarkers; D019468:Disease Management; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: Haematology; Immunology; Oncology