First- and Second-Line Systemic Treatment of Acute Graft-versus-Host Disease: Recommendations of the American Society of Blood and Marrow Transplantation

Paul J. Martin, J. Douglas Rizzo, John R. Wingard, Karen Ballen, Peter T. Curtin, Corey Cutler, Mark R. Litzow, Yago Nieto, Bipin N. Savani, Jeffrey R. Schriber, Paul J. Shaughnessy, Donna A. Wall, Paul A. Carpenter

Research output: Contribution to journalReview article

262 Scopus citations

Abstract

Despite prophylaxis with immunosuppressive agents or a variety of other approaches, many patients suffer from acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic cell transplantation. Although consensus has emerged supporting the use of high-dose methylprednisolone or prednisone for initial treatment of aGVHD, practices differ among centers with respect to the initial glucocorticoid dose, the use of additional immunosuppressive agents, and the approach to withdrawal of treatment after initial improvement. Despite many studies, practices vary considerably with respect to the selection of agents for treatment of glucocorticoid-resistant or refractory GVHD. Investigators and clinicians have recognized the lack of progress and lamented the absence of an accepted standard of care for secondary treatment of aGVHD. The American Society of Blood and Marrow Transplantation has developed recommendations for treatment of aGVHD to be considered by care providers, based on a comprehensive and critical review of published reports. Because the literature provides little basis for a definitive guideline, this review also provides a framework for the interpretation of previous results and the design of future studies.

Original languageEnglish (US)
Pages (from-to)1150-1163
Number of pages14
JournalBiology of Blood and Marrow Transplantation
Volume18
Issue number8
DOIs
StatePublished - Aug 1 2012

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Keywords

  • Acute graft-versus-host disease
  • Hematopoietic cell transplantation
  • Treatment

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Martin, P. J., Rizzo, J. D., Wingard, J. R., Ballen, K., Curtin, P. T., Cutler, C., Litzow, M. R., Nieto, Y., Savani, B. N., Schriber, J. R., Shaughnessy, P. J., Wall, D. A., & Carpenter, P. A. (2012). First- and Second-Line Systemic Treatment of Acute Graft-versus-Host Disease: Recommendations of the American Society of Blood and Marrow Transplantation. Biology of Blood and Marrow Transplantation, 18(8), 1150-1163. https://doi.org/10.1016/j.bbmt.2012.04.005