Acute graft-vs-host disease, pathophysiology, prevention, and treatment: Something old and something new

Abstract

Acute graft-vs-host disease (aGVHD) is a serious and potentially life-threatening complication that can occur after allogeneic hematopoietic stem cell transplantation (allo-HSCT). It is characterized by the activation of innate immune cells during a cytokine storm, often triggered by tissue injury. aGVHD typically impacts the skin, liver, and gastrointestinal tract, resulting in a range of clinical manifestations that can hinder post-transplant recovery, increase risk of infection, and significantly affect patient survival. This review article integrates current knowledge on the prevalence, risk factors, pathophysiology, clinical presentation, and grading of aGVHD. Additionally, we explore existing strategies for prevention and treatment, including the use of immunosuppressive therapies and novel pharmacological agents. By synthesizing recent research findings and clinical insights, we aim to deepen the understanding of aGVHD and promote advancements in its management, ultimately enhancing the quality of life and survival outcomes for patients undergoing allo-HSCT.

Keywords: aGVHD; cytokine; grading; prevention; quality of life; treatment.