Treatment Advances in Graft-Vs-Host Disease: A 48-Year-Old Man With Chronic Graft-Vs-Host Disease

A panelist discusses how graft-vs-host disease (GVHD) manifests through a complex constellation of symptoms affecting multiple organ systems, including the skin (rash, itching), gastrointestinal tract (diarrhea, nausea, abdominal pain), liver (elevated enzymes, jaundice), and lungs (shortness of breath, cough), with severity assessment typically following established criteria.

A panelist discusses how steroid therapy remains the cornerstone of acute graft-vs-host disease (GVHD) treatment, with treatment protocols typically starting with prednisone at doses ranging from 1 to 2 mg/kg/day depending on disease severity, though optimal dosing strategies continue to be refined through clinical research.

A panelist discusses how identifying steroid-dependent or steroid-refractory (SR) graft-vs-host disease (GVHD) requires careful clinical monitoring, with the determination typically made when patients show disease progression during prednisone taper, inadequate response after 5 to 7 days of treatment, or persistent disease despite 2 weeks of appropriate steroid therapy.

A panelist discusses how managing adverse events (AEs) in patients with chronic graft-vs-host disease (cGVHD) treated with ruxolitinib requires a structured monitoring approach that balances therapeutic efficacy with patient safety through regular clinical evaluations, laboratory assessments, and proactive management strategies tailored to individual risk profiles.

A panelist discusses how the treatment landscape for chronic graft-vs-host disease (cGVHD) has evolved significantly in recent years, with several pivotal clinical trials beyond REACH3 informing our approach, including the REACH1 and REACH2 trials for acute GVHD; the ROCKstar trial supporting belumosudil approval; and studies evaluating ibrutinib, axatilimab, and extracorporeal photopheresis.

A panelist discusses how successful management of chronic graft-vs-host disease (cGVHD) requires a multifaceted approach that combines prompt recognition, strategic intervention, and comprehensive supportive care to optimize both disease control and quality of life for transplant survivors.