Current Practices and Future Directions for Treatment of Graft-vs-Host Disease (GVHD)

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.

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.

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.

Dr Cutler leads a discussion on the approach to management of chronic GVHD and whether complete response is a realistic end point.

Dr Chen provides an overview of the prevalence of steroid refractory GVHD and leads a discussion on how steroid refractory GVHD is defined.

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.

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.

All panelists provide their final thoughts on the current landscape and future directions in graft-vs-host disease (GVHD).