Pidala, Joseph and Kitko, Carrie and Lee, Stephanie J. and Carpenter, Paul and Cuvelier, Geoffrey D. E. and Holtan, Shernan and Flowers, Mary E. and Cutler, Corey and Jagasia, Madan and Gooley, Ted and Palmer, Joycelynne and Randolph, Tim and Levine, John E. and Ayuk, Francis and Dignan, Fiona and Schoemans, Helene and Tkaczyk, Eric and Farhadfar, Nosha and Lawitschka, Anita and Schultz, Kirk R. and Martin, Paul J. and Sarantopoulos, Stefanie and Inamoto, Yoshihiro and Socie, Gerard and Wolff, Daniel and Blazar, Bruce and Greinix, Hildegard and Paczesny, Sophie and Pavletic, Steven and Hill, Geoffrey (2021) National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: IIb. The 2020 Preemptive Therapy Working Group Report. TRANSPLANTATION AND CELLULAR THERAPY, 27 (8). pp. 632-641. ISSN 2666-6375, 2666-6367
Full text not available from this repository. (Request a copy)Abstract
Chronic graft-versus-host disease (GVHD) commonly occurs after allogeneic hematopoietic cell transplantation (HCT) despite standard prophylactic immune suppression. Intensified universal prophylaxis approaches are effective but risk possible overtreatment and may interfere with the graft-versus-malignancy immune response. Here we summarize conceptual and practical considerations regarding preemptive therapy of chronic GVHD, namely interventions applied after HCT based on evidence that the risk of developing chronic GVHD is higher than previously appreciated. This risk may be anticipated by clinical factors or risk assignment biomarkers or may be indicated by early signs and symptoms of chronic GVHD that do not fully meet National Institutes of Health diagnostic criteria. However, truly preemptive, individualized, and targeted chronic GVHD therapies currently do not exist. In this report, we (1) review current knowledge regarding clinical risk factors for chronic GVHD, (2) review what is known about chronic GVHD risk assignment biomarkers, (3) examine how chronic GVHD pathogenesis intersects with available targeted therapeutic agents, and (4) summarize considerations for preemptive therapy for chronic GVHD, emphasizing trial development, including trial design and statistical considerations. We conclude that robust risk assignment models that accurately predict chronic GVHD after HCT and early-phase preemptive therapy trials represent the most urgent priorities for advancing this novel area of research. (C) 2021 Published by Elsevier Inc. on behalf of The American Society for Transplantation and Cellular Therapy.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MURINE CHRONIC GVHD; B-CELLS; RISK-FACTORS; T-CELLS; PLASMA BIOMARKERS; BRONCHIOLITIS OBLITERANS; MARROW-TRANSPLANTATION; BCR RESPONSIVENESS; PREDICTIVE-VALUE; CHILDREN; Chronic graft-versus-host disease; Allogeneic hematopoietic cell transplantation; Consensus; Risk assignment biomarkers; Preemptive therapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 04 Oct 2022 07:03 |
| Last Modified: | 04 Oct 2022 07:03 |
| URI: | https://pred.uni-regensburg.de/id/eprint/48185 |
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