Chronic graft‐versus‐host disease: Current management paradigm and future perspectives. (14th August 2018)

• Record Type: Journal Article
• Authors: Mawardi, Hani; Hashmi, Shahrukh K.; Elad, Sharon; Aljurf, Mahmoud; Treister, Nathaniel
• Is Part Of: Oral diseases. Volume 25:Number 4(2019)
• Page Start: 931
• Page End: 948
• Publication Date: 2018-08-14
• Subjects: GVHD -- matched -- oral -- transplant; Mouth -- Diseases -- Research -- Periodicals; 617.522
• DOI: 10.1111/odi.12936
• Languages: English
• ISSNs: 1354-523X

Abstract

Abstract: Introduction: The field of allogeneic hematopoietic cell transplantation (allo‐HCT) began in the 1950s, and despite a seven decade history of remarkable clinical advances, graft‐versus‐host‐disease (GVHD) remains the greatest obstacle in its success due to considerable morbidity and mortality. Graft‐versus‐host disease is the second leading cause of transplantation‐related mortality (TRM) after relapse of primary disease. There are two main types of GVHD—acute and chronic—differing in the pathogenesis, time of onset, and clinical presentation. Objective: This review provides a comprehensive overview of chronic GVHD pathophysiology and current management paradigms, as well as consideration of promising novel therapies. Conclusion: Chronic GVHD is a serious disease which may be active for years, or even decades, requiring potentially years of immunosuppressive therapies and placing patients at risk for a number of late complications. While the oral cavity has long been recognized to be a prominent target of GVHD, and in particular, chronic GVHD, it must be recognized and appreciated that it is a complex systemic disease with a wide spectrum of clinical manifestations.