Steroid-refractory chronic graft-versus-host disease: treatment options and patient management

被引：44

作者：

Wolff, Daniel ^{[1
]}

Fatobene, Giancarlo ^{[2
,3
,4
]}

Rocha, Vanderson ^{[2
,3
,4
]}

Kroeger, Nicolaus ^{[5
]}

Flowers, Mary E. ^{[6
,7
]}

机构：

[1] Univ Hosp Regensburg, Dept Internal Med 3, Regensburg, Germany

[2] Univ Sao Paulo HC FMUSP, Hosp Clin, Fac Med, Sao Paulo, Brazil

[3] Vila Nova Star Hosp, Sao Paulo, Brazil

[4] Rede DOr, IDOR, Sao Paulo, Brazil

[5] Univ Med Ctr Hamburg, Dept Stem Cell Transplantat, Hamburg, Germany

[6] Univ Washington, Fred Hutchinson Canc Res Ctr, Clin Res Div, Seattle, WA 98195 USA

[7] Univ Washington, Dept Med, Seattle, WA USA

来源：

BONE MARROW TRANSPLANTATION | 2021年 / 56卷 / 09期

关键词：

STEM-CELL TRANSPLANTATION; CONSENSUS DEVELOPMENT PROJECT; BRONCHIOLITIS OBLITERANS SYNDROME; LOW-DOSE METHOTREXATE; TERM-FOLLOW-UP; BONE-MARROW; EXTRACORPOREAL PHOTOPHERESIS; CLINICAL-TRIALS; CHRONIC GVHD; PHASE-II;

D O I：

10.1038/s41409-021-01389-5

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

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.

引用

页码：2079 / 2087

页数：9

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