GvHD Treatment & Symptoms
- First-line therapy for GvHD is systemic immunosuppression, usually with corticosteroids1.
- In aGvHD, a systemic inflammatory reaction can damage various organs - most commonly the skin, gut, and liver2.
- In cGvHD, the lungs, muscles, and joints may also be affected2.
Skin
Severe redness with patchy rash, itching, and scaling2
Gut
Mucosal inflammation leads to moderate to severe watery diarrhea with abdominal cramps. This can cause malnutrition, and Weight loss2
Liver
Involvement is indicated by jaundice due to elevated bilirubin levels; Grade IV severity is marked by levels over 15 mg/dl (normal < 2 mg/dl)3.
Clear goals for better outcomes
Achieving a higher Overall Response without the requirement of additional systemic therapies*4
Achieving failure free survival#4
Reduction of average steroid dose5
Reducing the risk of relapse, disease recurrence, or death caused by the underlying condition4
* The 1ry endpoint Defined as overall response at day 28, which was defined as the proportion of patients who had a complete response or partial response as compared with baseline organ staging without the use of additional systemic therapy for acute GVHD.4
# Failure-free survival (time from randomization to relapse or progression of hematologic disease, non–relapse-related death, or the addition of new systemic therapy for acute GVHD.4
References
(NCCN Guidelines®) for Hematopoietic Cell Transplantation (HCT).V.2.2025. Available at https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1501. [Last accessed: 06/10/2025].
Murray J, Stringer J, Hutt D. Graft-versus-host disease (GvHD).The European Blood and Marrow Transplantation Text Book .Available at https://www.ncbi.nlm.nih.gov/books/NBK543657/. {Last accessed: 06/10/2025].
Jacobsohn DA, Vogelsang GB. Acute graft versus host disease. Orphanet journal of rare diseases. 2007 Sep 4;2(1):35.
Zeiser R, von Bubnoff N, Butler J, Mohty M, Niederwieser D, Or R, Szer J, Wagner EM, Zuckerman T, Mahuzier B, Xu J. Ruxolitinib for glucocorticoid-refractory acute graft-versus-host disease. New England Journal of Medicine. 2020 May 7;382(19):1800-10.
Zeiser R, Polverelli N, Ram R, Hashmi SK, Chakraverty R, Middeke JM, Musso M, Giebel S, Uzay A, Langmuir P, Hollaender N. Ruxolitinib for glucocorticoid-refractory chronic graft-versushost disease. New England Journal of Medicine. 2021 Jul 15;385(3):228-38.
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