Prophylaxis and Treatment of Acute Graft-Versus-Host Disease
2006; Elsevier BV; Volume: 43; Issue: 1 Linguagem: Inglês
10.1053/j.seminhematol.2005.09.007
ISSN1532-8686
AutoresNelson J. Chao, Benny J. Chen,
Tópico(s)T-cell and B-cell Immunology
ResumoAcute graft-versus-host disease (GVHD) remains a major obstacle to successful allogeneic hematopoietic stem cell transplantation (HSCT). The ability to prevent GVHD—the application of successful prophylaxis—is crucial as treatment when prophylaxis fails or remains suboptimal. A calcineurin inhibitor in combination with methotrexate is still the mainstream regimen for prophylaxis of GVHD. Despite a steady increase in the repertoire of available drugs, corticosteroids remain the first-line therapy for patients who fail prevention and develop GVHD. Pan T-cell depletion studies suggest that success in prophylaxis and treatment of GVHD will depend on whether GVHD can be prevented without losing anti-malignancy and anti-infectious effects. Better understanding of the allogeneic response that is responsible for GVHD will facilitate the development of such an approach.
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