GvHD Treatment Guidelines
Category 1 Recommendation
a For patients receiving immunosuppressive agents for GVHD, see NCCN Guidelines for Prevention and Treatment of Cancer-Related Infections.
b An FDA-approved biosimilar is an appropriate substitute for any recommended systemic biologic therapy in the NCCN Guidelines.
c Ruxolitinib is FDA approved for the treatment of adult and pediatric patients (age ≥12 years) with either steroid-refractory acute GVHD, or chronic GVHD after failure of one or two lines of systemic therapy.
d Psoralen and ultraviolet A irradiation (PUVA) may be used for sclerotic or cutaneous GVHD if ECP is not available or feasible.
e Ibrutinib is FDA approved for the treatment of adult and pediatric patients ≥1 year with chronic GVHD after failure of one or more lines of systemic therapy. Ibrutinib should be used with caution in patients with a history of heart arrhythmias or heightened risk of bleeding.
f Belumosudil is FDA approved for the treatment of adult and pediatric patients (age ≥12 years) with chronic GVHD after failure of two or more prior lines of systemic therapy.
g Axatilimab-csfr is FDA approved for the treatment of adult and pediatric patients weighing ≥40 kg with chronic GVHD after failure of at least two prior lines of systemic therap
References
(NCCN Guidelines®) for Hematopoietic Cell Transplantation (HCT).V.3.2025. Available at https://www.nccn.org/professionals/physician_gls/pdf/hct.pdf . [Last accessed: 06/10/2025].
Penack O, Marchetti M, Aljurf M, Arat M, Bonifazi F, Duarte RF, Giebel S, Greinix H, Hazenberg MD, Kröger N, Mielke S. Prophylaxis and management of graft-versus-host disease after stem-cell transplantation for haematological malignancies: updated consensus recommendations of the European Society for Blood and Marrow Transplantation. The Lancet Haematology. 2024 Feb 1;11(2):e147-59.Available at https://linkinghub.elsevier.com/retrieve/pii/S2352-3026(23)00342-3 [Last accessed: 05/10/2025].
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