TY - JOUR
T1 - Chronic Graft-Versus-Host Disease after allogeneic stem cell transplantation
T2 - Challenges in prevention, science, and supportive care
AU - Joseph, Richard W.
AU - Couriel, Daniel R.
AU - Komanduri, Krishna V.
PY - 2008
Y1 - 2008
N2 - Chronic GVHD (cGVHD) remains one of the most significant complications affecting the quality of life of long-term survivors of allogeneic stem cell transplant (SCT). Recent advancements in SCT, including the adoption of reduced-intensity conditioning regimens and improvements in inpatient supportive care, have yielded dramatic reductions in early mortality and led to the expanding use of allogeneic SCT in a broader range of patients, including the elderly. In turn, this development has resulted in a growing number of SCT survivors who remain free of their underlying malignancies but who require care for long-term complications, including cGVHD. cGVHD may have protean manifestations and may pose unique diagnostic and therapeutic challenges. To address inconsistencies in the diagnosis, treatment, and supportive care of cGVHD, experts within the SCT community have worked to develop consensus guidelines; these efforts have yielded more precise definitions and will facilitate more uniform clinical trials. With an increase in SCT survivorship, the management of patients with cGVHD is performed as a partnership between SCT physicians and primary oncologists. This review is designed to help general oncologists understand the current state of cGVHD, including its pathogenesis and treatment. The review places particular emphasis on general principles governing the optimal supportive management of cGVHD and examines recent consensus recommendations regarding its diagnosis and management by organ system.
AB - Chronic GVHD (cGVHD) remains one of the most significant complications affecting the quality of life of long-term survivors of allogeneic stem cell transplant (SCT). Recent advancements in SCT, including the adoption of reduced-intensity conditioning regimens and improvements in inpatient supportive care, have yielded dramatic reductions in early mortality and led to the expanding use of allogeneic SCT in a broader range of patients, including the elderly. In turn, this development has resulted in a growing number of SCT survivors who remain free of their underlying malignancies but who require care for long-term complications, including cGVHD. cGVHD may have protean manifestations and may pose unique diagnostic and therapeutic challenges. To address inconsistencies in the diagnosis, treatment, and supportive care of cGVHD, experts within the SCT community have worked to develop consensus guidelines; these efforts have yielded more precise definitions and will facilitate more uniform clinical trials. With an increase in SCT survivorship, the management of patients with cGVHD is performed as a partnership between SCT physicians and primary oncologists. This review is designed to help general oncologists understand the current state of cGVHD, including its pathogenesis and treatment. The review places particular emphasis on general principles governing the optimal supportive management of cGVHD and examines recent consensus recommendations regarding its diagnosis and management by organ system.
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M3 - Review article
C2 - 19149321
AN - SCOPUS:59449106532
SN - 1544-6794
VL - 6
SP - 361
EP - 372
JO - Journal of Supportive Oncology
JF - Journal of Supportive Oncology
IS - 8
ER -