Prophylaxis and treatment of acute graft-versus-host disease

被引:44
作者
Chao, NJ [1 ]
Chen, BJ [1 ]
机构
[1] Duke Univ, Med Ctr, Div Cellular Therapy BMT, Dept Med & Immunol, Durham, NC 27705 USA
关键词
D O I
10.1053/j.seminhematol.2005.09.007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Acute graft-versus-host disease (GVHD) remains a major obstacle to successful allogeneic hematopoietic stem cell transplantation (HSCT). The ability to prevent GVHD - the application of successful prophylaxis - is crucial as treatment when prophylaxis fails or remains suboptimal. A calcineurin inhibitor in combination with methotrexate is still the mainstream regimen for prophylaxis of GVHD. Despite a steady increase in the repertoire of available drugs, corticosteroids remain the first-line therapy for patients who fail prevention and develop GVHD. Pan T-cell depletion studies suggest that success in prophylaxis and treatment of GVHD will depend on whether GVHD can be prevented without losing anti-malignancy and anti-infectious effects. Better understanding of the allogeneic response that is responsible for GVHD will facilitate the development of such an approach. © 2006 Elsevier Inc. All rights reserved.
引用
收藏
页码:32 / 41
页数:10
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