Steroid-refractory chronic graft-versus-host disease: treatment options and patient management
Chronic graft-versus-host disease (cGVHD) is one of the major causes of late mortality after allogenic hematopoietic stem cell transplantation. Moderate-to-severe cGVHD is associated with poor health-related quality of life and substantial disease burden. While corticosteroids with or without calcin...
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Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2021-09, Vol.56 (9), p.2079-2087 |
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Format: | Artikel |
Sprache: | eng |
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Zusammenfassung: | Chronic graft-versus-host disease (cGVHD) is one of the major causes of late mortality after allogenic hematopoietic stem cell transplantation. Moderate-to-severe cGVHD is associated with poor health-related quality of life and substantial disease burden. While corticosteroids with or without calcineurin inhibitors comprise the first-line treatment option, the prognosis for patients with steroid-refractory cGVHD (SR-cGVHD) remains poor. The mechanisms underlying steroid resistance are unclear, and there are no standard second-line treatment guidelines for patients with SR-cGVHD. In this review, we provide an overview on current treatment options of cGVHD and use a series of theoretical case studies to elucidate the rationale of choices of second- and third-line treatment options for patients with SR-cGVHD based on individual patient profiles. |
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ISSN: | 0268-3369 1476-5365 |
DOI: | 10.1038/s41409-021-01389-5 |