Update on the management of acute graft-versus-host disease

Acute graft-versus-host disease is one of the commonest complications after allogeneic stem cell transplantation. Recent advances in its prevention and therapy are giving new hope to patients with this disease. This review covers the major advances in prophylaxis and therapy for this problem.

The use of novel approaches for prophylaxis such as posttransplant cyclophosphamide and non-methotrexate-containing regimens is discussed. The results of therapy with new agents such as pentostatin, pulse cyclophosphamide, long-wavelength ultraviolet A phototherapy, and monoclonal antibodies such as denileukin diftitox or etanercept are reviewed.

Without question, outcome in patients who develop graft-versus-host disease is improving. With better supportive care, and more effective prophylaxis and therapy, these patients have an improved chance for full recovery. Patients should be enrolled, when possible, in studies aimed to prevent and treat graft-versus-host disease.