Steroid-refractory aGvHD
Learn what happens when acute GvHD resists initial treatment
Risk Matters!
GvHD is a common and potentially deadly complication of alloHSCT 3
- 25657 alloHSCT procedures are carried out world wide*4
- The number of alloHSCT continues to grow5
Symptoms of aGvHD include
Skin
- Maculopapular rash5
- Blistering and ulceration in severe cases5
GI
- Nausea5
- Anorexia5
- Vomiting5
- Watery Diarrhea5
- Positive Histological Findings5
Liver
- Bile duct destruction5
- Elevated serum bilirubin levels5
GvHD, graft-versus-host disease; allo-HSCT, Allogenic hematopoietic stem cell transplantation; GI, gastrointestinal; OS, overall survival
*This Number is the sum of allo-HSCT procedures performed as following 17,641 first transplants,1143 subsequent transplants, 839 allogenic after previous autologous, 3545 transplantation under the age of 18 in both dedicated and joint adult-pediatric units, 2495 procedures were performed in dedicated pediatric centers
Steroid-refractory aGvHD
Learn what happens when acute GvHD resists initial treatment
Chronic disease can develop in 3 ways 9!
Distinctions between acute and chronic disease are poorly defined and some patients may present with elements of each, known as
“overlapping syndrome”7
References
Yu J, Parasuraman S, Shah A, Weisdorf D. Mortality, length of stay and costs associated with acute graft-versus-host disease during hospitalization for allogeneic hematopoietic stem cell transplantation. Current medical research and opinion. 2019 Jun 3;35(6):983-8
Schoemans HM, Lee SJ, Ferrara JL, Wolff D, Levine JE, Schultz KR. EBMT (European Society for Blood and Marrow Transplantation) Transplant Complications Working Party and the “EBMT− NIH (National Institutes of Health)− CIBMTR (Center for International Blood and Marrow Transplant Research) GvHD Task Force”. Bone Marrow Transplant. 2018;53(11):1401-15
Zeiser R, Blazar BR. Acute graft-versus-host disease—biologic process, prevention, and therapy. New England Journal of Medicine. 2017 Nov 30;377(22):2167-79
Passweg JR, Baldomero H, Bader P. European Society for Blood and Marrow Transplantation (EBMT). Hematopoietic SCT in Europe. 2013:476-82
D'Souza A, Lee S, Zhu X, Pasquini M. Current use and trends in hematopoietic cell transplantation in the United States. Biology of Blood and Marrow Transplantation. 2017 Sep 1;23(9):1417-2
Miller HK, Braun TM, Stillwell T, Harris AC, Choi S, Connelly J, Couriel D, Goldstein S, Kitko CL, Magenau J, Pawarode A. Infectious risk after allogeneic hematopoietic cell transplantation complicated by acute graft-versus-host disease. Biology of Blood and Marrow Transplantation. 2017 Mar1;23(3):522-8
Ferrara JL, Levine JE, Reddy P, Holler E. Graft-versus-host disease. The Lancet. 2009 May 2;373(9674):1550-61
DeFilipp Z, Couriel DR, Lazaryan A, Bhatt VR, Buxbaum NP, Alousi AM, Olivieri A, Pulanic D, Halter JP, Henderson LA, Zeiser R. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: III. The 2020 treatment of chronic GVHD report. Transplantation and cellular therapy. 2021 Sep 1;27(9):729-37. Available at: https://www.sciencedirect.com/science/article/pii/S2666636721008952. [Last accessed: 06/10/2025].
Grube M, Holler E, Weber D, Holler B, Herr W, Wolff D. Risk factors and outcome of chronic graft-versus-host disease after allogeneic stem cell transplantation—results from a single-center observational study. Biology of Blood and Marrow Transplantation. 2016 Oct 1;22(10):1781-91
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