Immunopathology and biology-based treatment of steroid-refractory graft-versus-host disease.
Journal
Blood
ISSN: 1528-0020
Titre abrégé: Blood
Pays: United States
ID NLM: 7603509
Informations de publication
Date de publication:
23 07 2020
23 07 2020
Historique:
received:
05
11
2019
accepted:
24
01
2020
pubmed:
12
6
2020
medline:
26
2
2021
entrez:
12
6
2020
Statut:
ppublish
Résumé
Acute graft-versus-host disease (GVHD) is 1 of the major life-threating complications after allogeneic cell transplantation. Although steroids remain first-line treatment, roughly one-half of patients will develop steroid-refractory GVHD (SR-GVHD), which portends an extremely poor prognosis. Many agents that have shown encouraging response rates in early phase 1/2 trials for prevention and treatment have been unsuccessful in demonstrating a survival advantage when applied in the setting of SR-GVHD. The discovery of novel treatments has been further complicated by the absence of clinically informative animal models that address what may reflect a distinct pathophysiology. Nonetheless, the combined knowledge of established bone marrow transplantation models and recent human trials in SR-GVHD patients are beginning to illuminate novel mechanisms for inhibiting T-cell signaling and promoting tissue tolerance that provide an increased understanding of the underlying biology of SR-GVHD. Here, we discuss recent findings of newly appreciated cellular and molecular mechanisms and provide novel translational opportunities for advancing the effectiveness of treatment in SR-GVHD.
Identifiants
pubmed: 32526035
pii: S0006-4971(20)61862-6
doi: 10.1182/blood.2019000953
pmc: PMC7378454
doi:
Substances chimiques
Steroids
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
429-440Subventions
Organisme : NIAID NIH HHS
ID : K23 AI123595
Pays : United States
Informations de copyright
© 2020 by The American Society of Hematology.
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