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Recent advances in the management of graft-versus-host disease
  1. S Dhir1,
  2. M Slatter2,
  3. R Skinner1,2
  1. 1Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital, Newcastle upon Tyne, UK
  2. 2Children's Haemopoietic Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle upon Tyne, UK
  1. Correspondence to Dr R Skinner, Department of Paediatric and Adolescent Oncology/BMT, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK; Roderick.Skinner{at}ncl.ac.uk

Abstract

Graft-versus-host disease (GvHD) remains a significant hurdle in overcoming the morbidity and mortality associated with haemopoietic stem cell transplantation in children. Better understanding of its pathobiology is facilitating the development of biomarkers for the severity of acute GvHD and treatment response, and has led to the introduction of a more prognostically relevant grading system for chronic GvHD. These enable stratification of appropriate prophylactic and treatment strategies according to the risk profiles of individual patients. Steroid-refractory acute GvHD has a poor prognosis, but early reports of the use of new immunosuppressive drugs and especially cellular treatments with extracorporeal photopheresis and mesenchymal stem cells suggest improved short-term outcomes and offer the promise of increased longer-term survival rates.

  • Haematology
  • Immunology
  • Oncology

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