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

Zachariah DeFilipp, Daniel R. Couriel, Aleksandr Lazaryan, Vijaya Raj Bhatt, Nataliya P. Buxbaum, Amin M. Alousi, Attilio Olivieri, Drazen Pulanic, Joerg P. Halter, Lori A. Henderson, Robert Zeiser, Ted A. Gooley, Kelli P.A. MacDonald, Daniel Wolff, Kirk R. Schultz, Sophie Paczesny, Yoshihiro Inamoto, Corey S. Cutler, Carrie L. Kitko, Joseph A. PidalaStephanie J. Lee, Gerard Socie, Stefanie Sarantopoulos, Steven Z. Pavletic, Paul J. Martin, Bruce R. Blazar, Hildegard T. Greinix

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Positive results from recent clinical trials have significantly expanded current therapeutic options for patients with chronic graft-versus-host disease (GVHD). However, new insights into the associations between clinical characteristics of chronic GVHD, pathophysiologic mechanisms of disease, and the clinical and biological effects of novel therapeutic agents are required to allow for a more individualized approach to treatment. The current report is focused on setting research priorities and direction in the treatment of chronic GVHD. Detailed correlative scientific studies should be conducted in the context of clinical trials to evaluate associations between clinical outcomes and the biological effect of systemic therapeutics. For patients who require systemic therapy but not urgent initiation of glucocorticoids, clinical trials for initial systemic treatment of chronic GVHD should investigate novel agents as monotherapy without concurrently starting glucocorticoids, to avoid confounding biological, pathological, and clinical assessments. Clinical trials for treatment-refractory disease should specifically target patients with incomplete or suboptimal responses to most recent therapy who are early in their disease course. Close collaboration between academic medical centers, medical societies, and industry is needed to support an individualized, biology-based strategic approach to chronic GVHD therapy.

Original languageEnglish (US)
Pages (from-to)729-737
Number of pages9
JournalTransplantation and Cellular Therapy
Volume27
Issue number9
DOIs
StatePublished - Sep 2021

Keywords

  • Allogeneic hematopoietic cell transplantation
  • Chronic graft-versus-host disease
  • Consensus
  • Initial therapy
  • Treatment refractory

ASJC Scopus subject areas

  • Hematology
  • Transplantation
  • Immunology and Allergy
  • Cell Biology
  • Molecular Medicine
  • Medicine(all)

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