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Review
. 2021 Dec 10;2021(1):648-654.
doi: 10.1182/hematology.2021000301.

Updates in chronic graft-versus-host disease

Betty K Hamilton  1
Affiliations
Review

Updates in chronic graft-versus-host disease

Betty K Hamilton. Hematology Am Soc Hematol Educ Program. .

Abstract

Chronic graft-versus-host disease (GVHD) is the leading cause of late morbidity and mortality after allogeneic hematopoietic cell transplantation. Symptoms and manifestations of chronic GVHD are heterogeneous and pleomorphic, and there are no standard treatments beyond corticosteroids. Therapy is typically prolonged, and chronic GVHD and its treatment are associated with adverse effects that have a significant impact on long-term quality of life and functional status. Several advances have been made over the last 2 decades to define the diagnosis of chronic GVHD as well as its severity and response criteria for clinical trials. Further understanding into the biologic mechanisms of the development of chronic GVHD has led to the investigation of several novel immunomodulatory and targeted therapies. Multi-institutional collaboration and pharmaceutical support in the development of therapies based on sound biologic mechanisms and clinical trials with defined end points and responses have led to several promising agents on the horizon of approval for treatment of chronic GVHD. This article reviews advances in our knowledge of chronic GVHD and its biologic framework to improve approaches to prevention and treatment.

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Conflict of interest statement

Betty K. Hamilton: consultancy: Syndax, Equilium.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Proposed biologic phases of chronic GVHD. A few novel therapeutic approaches targeting biologic pathways are highlighted. Reproduced with permission from the Cleveland Clinic Center for Medical Art and Photography.
See this image and copyright information in PMC

References

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