Approaches for the prevention of graft-versus-host disease following hematopoietic cell transplantation

Abstract

Allogeneic hematopoietic cell transplantation is an important therapeutic option for malignant and nonmalignant diseases, but the more widespread application of the therapy remains limited by the occurrence of graft-versus-host disease (GVHD). GVHD results from immune-mediated injury by donor immune cells against tissues in the hematopoietic cell transplantation recipient, and can be characterized as acute or chronic depending on the time of onset and site of organ involvement. The majority of efforts have focused on GVHD prevention. Calcineurin inhibitors are the most widely used agents and are included in almost all regimens. Despite current prophylaxis strategies, 40–70% of patients remain at risk for developing GVHD. Herein, we review standard and emerging therapies used in GVHD management.