Opinion

Video

Patient Case Studies of GvHD

Provide detailed case studies highlighting the development, clinical presentation, multidisciplinary management, and outcomes of patients with acute and chronic GvHD following allo-HSCT.

This is a video synopsis/summary of a Peer Exchange featuring Miguel-Angel Perales, MD; Nelli Bejanyan, MD; Amandeep Salhotra, MD; and Arpita Gandhi, MD, MS.

The panel discusses the challenge of relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT), which remains the leading cause of mortality in this setting. Regardless of the donor type, about 50% of patients who die after 100 days of allogeneic transplantation succumb to relapse. Prevention of relapse is crucial, as treatment options for post-transplant relapse are limited.

A Center for International Blood and Marrow Transplant Research study reported in 2015 showed that among 1800 patients who relapsed after allogeneic transplantation, only 30% achieved subsequent complete remission with chemotherapy, and these remissions were not durable. Patients who appeared to benefit in terms of survival were those who received a second allogeneic transplantation or donor lymphocyte infusion (DLI). However, only 17% of patients were candidates for a subsequent allogeneic transplantation.

The timing of relapse is a critical predictor of subsequent survival. Patients who relapse within the first 6 months have a 1-year survival of only 4%, while those who relapse after 2 or more years, particularly at 3 to 4 years, can be salvaged with subsequent cellular-based therapy, such as DLI or DLI followed by a second allogeneic transplantation, with 30% to 40% achieving long-term survival.

Video synopsis is AI-generated and reviewed by OncLive® editorial staff.

Related Videos
Tracy George, MD
Elias Jabbour, MD
Neil Iyengar, MD, and Chandler Park, MD, FACP
Eytan M. Stein, MD
Eunice S. Wang, MD
Andrew Kuykendall, MD
Nosha Farhadfar, MD, and Chandler Park, MD, FACP
Prithviraj Bose, MD, and Chandler Park, MD, FACP
Eunice Wang, MD, and Chandler Park, MD, FACP
Muhamed Baljevic, MD, FACP and Jorge Cortes, MD, discuss upcoming studies and emerging data being presented at the 2024 ASH Annual Meeting.