Advances in the treatment of acute graft‐versus‐host disease

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) has been widely used for the treatment of hematologic malignant and non-malignant hematologic diseases and other diseases. However, acute graft-versus-host disease (GVHD) is a life-threatening complication of allogeneic transplantation. Acute GVHD may occur in 30% of transplant recipients, which is a syndrome of erythematous skin eruption, cholestatic liver disease and intestinal dysfunction, resulting from the activation of donor T lymphocytes by host antigen-presenting cells, resulting in an immune-mediated inflammatory response. Recent scientific advances in the understanding of the pathogenesis involved in the development of acute GVHD and clinical investigation have provided more effective therapeutic strategies for acute GVHD. This review focuses on major scientific and clinical advances in the treatment of acute GVHD.

Adoptive Immunotherapies After Allogeneic Hematopoietic Stem Cell Transplantation in Patients With Hematologic Malignancies

“…The ensuing proinflammatory cytokine storm recruits other effector cells, such as NK cells and macrophages. This perpetuates the proinflammatory cytokine cascade that is a hallmark of acute GVHD (aGVHD) and results in direct tissue damage, generally to a restricted set of organs (eg, skin, liver, and gastrointestinal tract) [7]. A second phase of GVHD, known as chronic GVHD (cGVHD), tends to have a more delayed presentation in patients, broader organ involvement, and clinical features that bear strong resemblance to autoimmune disorders [8].…”

Advances in Hematopoietic Stem Cell Transplantation

“…Chronic GVHD (cGVHD) occurs beyond 100 days of the HSCT and is a common complication of allogeneic graft. cGVHD occurs in 40% of HLA identical sibling HSCT, more than 50% of HLA-non-identical related HSCT and in 70% of matched unrelated HSCT patients [40,41]. It is the major cause of nonrelapse morbidity and mortality in allogeneic HSCT recipients and a major obstacle to improving outcomes.…”

Oral and IV Contrast Enhanced Ultrasonography of the digestive tract – a useful completion of the B-mode examination: a literature review and an exhaustive illustration through images

“…The early diagnosis of GVHD is very important for the early introduction of an adequate treatment which leads to a quick remission of the disease with «restitutio ad integrum» of the intestinal structure and function. CEUS's potential to determine and quantify the inflammatory changes of the bowel and 'friendly' character of the method, with the possibility of performing a bedside examination, has brought this method to the attention of researchers in this field [44].…”