Abstract
Acute graft-versus-host disease can occur after allogeneic haematopoietic cell transplantation. This Primer summarizes the epidemiology, pathophysiology, diagnosis, prevention and treatment of this disorder. This Primer also reviews future research avenues and the effect this disorder has on patients' quality of life. Acute graft-versus-host disease (GVHD) is a common immune complication that can ...
Abstract
Acute graft-versus-host disease can occur after allogeneic haematopoietic cell transplantation. This Primer summarizes the epidemiology, pathophysiology, diagnosis, prevention and treatment of this disorder. This Primer also reviews future research avenues and the effect this disorder has on patients' quality of life. Acute graft-versus-host disease (GVHD) is a common immune complication that can occur after allogeneic haematopoietic cell transplantation (alloHCT). Acute GVHD is a major health problem in these patients, and is associated with high morbidity and mortality. Acute GVHD is caused by the recognition and the destruction of the recipient tissues and organs by the donor immune effector cells. This condition usually occurs within the first 3 months after alloHCT, but later onset is possible. Targeted organs include the skin, the lower and upper gastrointestinal tract and the liver. Diagnosis is mainly based on clinical examination, and complementary examinations are performed to exclude differential diagnoses. Preventive treatment for acute GVHD is administered to all patients who receive alloHCT, although it is not always effective. Steroids are used for first-line treatment, and the Janus kinase 2 (JAK2) inhibitor ruxolitinib is second-line treatment. No validated treatments are available for acute GVHD that is refractory to steroids and ruxolitinib, and therefore it remains an unmet medical need.
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