Diagnosis and treatment of chronic graft-versus-host disease

Area of Science:

• Immunology
• Hematology
• Oncology

Background:

• Chronic graft-versus-host disease (GVHD) is a primary cause of non-relapse morbidity and mortality following hematopoietic stem cell transplant (HSCT).
• GVHD exhibits autoimmune-like characteristics, potentially affecting any organ, with common manifestations in the skin, oral cavity, liver, and lacrimal glands.
• Evolving transplant approaches influence GVHD incidence and presentation.

Purpose of the Study:

• To review the current understanding and challenges in chronic GVHD management.
• To highlight recent advancements in diagnostic and therapeutic strategies.
• To outline future directions for research and clinical practice.

Main Methods:

• Review of current literature and clinical trial data.
• Analysis of new prognostic scores and animal models.
• Examination of ongoing multicenter phase III therapy and biology studies.

Main Results:

• Chronic GVHD remains a significant clinical challenge post-HSCT.
• Recent developments include new prognostic tools and preclinical models.
• Large-scale clinical trials are investigating novel therapeutic and biological approaches.

Conclusions:

• Targeted therapies are needed to maintain the anti-leukemic effect of GVHD.
• Restoring normal immunity is crucial to reduce infectious complications.
• Future strategies should focus on balancing GVHD control with immune reconstitution.