Article Title

Diagnosis & Treatment of cGVHD After Allogeneic Stem Cell Transplant

Authors

Lakshmi Savitala-Damerla, University of LynchburgFollow

Specialty

Hematology

Abstract

Purpose: Diagnosis & Treatment of Chronic Graft versus Host Disease (cGVHD) in patients after Allogeneic Stem Cell Transplant.

Method: A PubMed literature search was conducted with search terms GVHD, stem cell transplant complications, treatment of GVHD. Eighty-eight pertinent articles were retrieved and served as the basis for this clinical review.

Results: Several options are available for the treatment of chronic GVHD in patients after allogeneic stem cell transplant. Although steroids remain the mainstay of treatment, several 2^nd and 3^rd line therapies are now emerging for steroid-refractory cGVHD and as alternative therapies.

Key Objectives:

1. To educate the target audience regarding the diagnosis and symptoms of chronic GVHD.
2. To educate the target audience regarding the treatment options for chronic GVHD.
3. To provide the audience with the understanding of the long-term sequelae of chronic GVHD.
4. To improve patient care in the treatment of chronic GVHD.

Conclusion: Graft versus host disease presents as acute or chronic, presenting within 100 days after allogeneic stem cell transplant in acute and presenting beyond 100 days in the chronic form. Recognizing and treating these symptoms is critical to a patient’s overall survival and quality of life. Chronic GVHD if left untreated or inadequately treated can account for significant long-term mortality, morbidity, and reduced quality of life for transplant patients. Chronic GVHD can lead to limited physical functioning inhibiting their return to work and ultimately lead to a profound impact on their psychosocial aspects of living.

A thorough evaluation of each patient based on their age, type of conditioning regimen used for the allogeneic transplant, type of GVHD prophylaxis used play a crucial role in understanding the long-term management of cGVHD. Beyond the gold standard treatment with corticosteroid therapy, the second-line and third-line treatments are not clearly outlined. Therefore, understanding newer modalities of treatment is important in achieving the goals of care as the ultimate goal of treatment of cGVHD is managing patient symptoms, minimizing infection complications, and providing manageable quality of life in the long run for these patients.

Recommended Citation

Savitala-Damerla, Lakshmi (2021) "Diagnosis & Treatment of cGVHD After Allogeneic Stem Cell Transplant," Lynchburg Journal of Medical Science: Vol. 3 : Iss. 4 , Article 55.
Available at: https://digitalshowcase.lynchburg.edu/dmscjournal/vol3/iss4/55