Graft-vs-Host Disease (GVHD) is a challenging complication of allogeneic transplantation. In this peer exchange, leaders in the field will share their thoughts on the biology and presentation of GVHD, the diagnosis and staging of GVHD, initial management of GVHD, and steroid-refractory GVHD.
EP. 1: Immunopathology and GVHD Incidence
Yi-Bin Chen , MD, provides an overview of how the landscape graft-vs-host disease (GVHD) has evolved over the past 3 decades. Corey Cutler, MD, PhD, FRCPC, provides an overview of GVHD biology. Potential risk factors for development of acute and chronic GVHD are discussed.
Richard Maziarz, MD, highlights the fact that graft-vs-host disease (GVHD) is a T-cell disease and then outlines qualitative and quantitative mechanisms that are used to prophylactically target the alloreactive T-cell population. A calcineurin inhibitor combined with methotrexate is the currently accepted standard of care for GVHD prophylaxis. Panelists weigh in on the use of post-transplant cyclophosphamide (PTCy) for prevention of GVHD.
EP. 3: Diagnosing & Staging of GVHD
Sophie Paczesny, MD, PhD, leads a discussion on diagnostic tests used in the setting of graft-vs-host disease and how patients are risk stratified. Whether organ biopsies are used routinely is also discussed.
EP. 4: Management of Acute GVHD
Yi-Bin Chen, MD, leads a discussion on systemic treatment approaches being used currently for the management of acute graft-vs-host disease, as well as those being considered for the future.
EP. 6: Steroid Refractory GVHD: Scope of the Problem
Dr Chen provides an overview of the prevalence of steroid refractory GVHD and leads a discussion on how steroid refractory GVHD is defined.
EP. 7: Steroid-Refractory Acute GVHD
Richard Maziarz, MD, provides an overview of the drug ruxolitinib, which was recently approved for use in steroid-refractory acute GVHD (graft-vs-host disease). He leads a discussion on the results of REACH-1 and REACH-2 and the experiences of the other panelists in using this drug.
EP. 8: Steroid-Refractory Chronic GVHD
Sophie Paczesny, MD, PhD, provides an overview of the drug ibrutinib for use in steroid-refractory chronic graft-vs-host disease (GVHD). She elicits thoughts from the panelists on how they envision this drug being used.