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Graft-vs-Host Disease Management in the Modern Era: Expert Insights on Incorporating Recent Advances Into Care

Corey Cutler, MD, MPH, FRCPC
Released: April 13, 2020
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References

  1. Zeiser R, Blazar BR. Acute graft-versus-host disease - biologic process, prevention, and therapy. N Engl J Med. 2017;377:2167-2179.
  2. Horowitz MM, Gale RP, Sondel PM, et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood.1990;75:555-562.
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  12. Bolaños-Meade J, Logan BR, Alousi A, et al. Phase 3 clinical trial of steroids/mycophenolate mofetil vs steroids/placebo as therapy for acute GVHD: BMT CTN 0802. Blood. 2014;124;3221-3227.
  13. Jagasia M, Perales MA, Schroeder MA, et al. Ruxolitinib for the treatment of steroid-refractory acute GVHD (REACH1): a multicenter, open-label, phase 2 trial. Blood. 2020 Mar 5 [Epub ahead of print].
  14. Jagasia M, Zeiser R, Arbushites M, et al. Ruxolitinib for the treatment of patients with steroid-refractory GVHD: an introduction to the REACH trials. Immunotherapy. 2018;10:391-402.
  15. ClinicalTrials.gov. GRAVITAS-301: a study of itacitinib or placebo in combination with corticosteroids for treatment of acute graft-versus-host disease. Available at: https://clinicaltrials.gov/ct2/show/NCT03139604. Accessed March 30, 2020.
  16. Watkins B, Qayed M, Bratrude B, et al. T cell costimulation blockade with abatacept nearly eliminates early severe acute graft versus host disease after HLA-mismatched (7/8 HLA matched) unrelated donor transplant, with a favorable impact on disease-free and overall survival. Program and abstracts of the 2018 Annual Meeting of the American Society of Hematology; December 9-12, 2017; Atlanta, Georgia. Abstract 212.
  17. Watkins BK, Qayed M, Bratude B, et al. T Cell costimulation blockade with CTLA4-Ig (abatacept) for acute GVHD prevention in HLA matched and mismatched unrelated donor transplantation: results of the first phase 2 trial. Biol Blood Marrow Transplant. 2019;25(Suppl):S51.
  18. Lee SJ, Vogelsang G, Gilman A, et al. A survey of diagnosis, management, and grading of chronic GVHD. Biol Blood Marrow Transplant. 2002;8:32-39.
  19. Palmer J, Chai X, Pidala J, et al. Predictors of survival, nonrelapse mortality, and failure-free survival in patients treated for chronic graft-versus-host disease. Blood. 2016;127:160-166.
  20. Pidala JA, Hamilton BK, Martin PJ, et al. The chronic graft-versus-host disease failure-free survival (cGVHD-FFS) index. Biol Blood Marrow Transplant. 2019;25:2468-2473.
  21. Cutler C, Koreth J, Ritz R. Mechanistic approaches for the prevention and treatment of chronic GVHD. Blood. 2017;129:22-29.
  22. Miklos D, Cutler CS, Arora M, et al. Ibrutinib for chronic graft-versus-host disease after failure of prior therapy. Blood. 2017;130:2243-2250.
  23. ClinicalTrials.gov. Ibrutinib in combination with corticosteroids vs placebo in combination with corticosteroids in subjects with new onset cGVHD (iNTEGRATE). Available at: https://clinicaltrials.gov/ct2/show/NCT02959944. Accessed March 30, 2020.
  24. Jagasia M, Scheid C, Socié G, et al. Randomized controlled study of ECP with methoxsalen as first-line treatment of patients with moderate to severe cGVHD. Blood Adv. 2019;3:2218-2229.
  25. Cutler C, Miklos D, Kim HT, et al. Rituximab for steroid-refractory chronic graft-versus-host disease. Blood. 2006;108:756-762.
  26. Koreth J, Kim HT, Jones KT, et al. Efficacy, durability, and response predictors of low-dose interleukin-2 therapy for chronic graft-versus-host disease. Blood. 2016;128:130-137.
  27. Zeiser R, Burchert A, Lengerke C, et al. Ruxolitinib in corticosteroid-refractory graft-versus-host disease after allogeneic stem cell transplantation: a multicenter survey. Leukemia. 2015;29:2062-2068.
  28. ClinicalTrials.gov. A study of ruxolitinib vs best available therapy (BAT) in patients with steroid-refractory chronic graft vs. host disease (GvHD) after bone marrow transplantation (REACH3). Available at: https://clinicaltrials.gov/ct2/show/NCT03112603. Accessed March 30, 2020.
  29. ClinicalTrials.gov. A study to evaluate the safety, tolerability, and activity of KD025 in subjects with chronic graft versus host disease. Available at: https://clinicaltrials.gov/ct2/show/NCT02841995. Accessed March 30, 2020.
  30. Jagasia M, Salhotra A, Bachier C, et al. KD025-208: a phase 2a study of KD025 for patients with chronic graft versus host disease (cGVHD)—pharmacodynamics and updated results. Program and abstracts of the 2018 Annual Meeting of the American Society of Hematology; December 1-4, 2018; San Diego, California. Abstract 602.
  31. Cutler CS, Arai S, Zoghi B, et al. Interim analysis of KD025-213: a phase 2, randomized, multicenter study to evaluate the efficacy and safety of KD025 in subjects with chronic graft versus host disease (cGVHD) after at least 2 prior lines of systemic therapy (The ROCKstar Study; NCT03640481). Program and abstracts of the 2020 Transplant & Cellular Therapy Meetings of ASTCT and CIBMTR February 19-23, 2020. Orlando, Florida. Abstract LBA-2.
  32. Luo ZK, Domenech-Estarellas E, Han A, et al. A novel transdermal treatment of chronic ocular graft-vs-host disease (OGVHD): a phase II clinic trial. Program and abstracts of the 2020 Transplant & Cellular Therapy Meetings of ASTCT and CIBMTR; February 19-23, 2020; Orlando, Florida. Abstract 38.
  33. Farag SS, Zaid MA, Nelson RP, et al. A prospective phase II clinical trial of CD26/dipeptidyl peptidase (DPP)-IV inhibition for prevention of acute graft versus host disease (aGVHD) following myeloablative allogeneic peripheral blood stem cell (PBSC) transplantation. Program and abstracts of the 2020 Transplant & Cellular Therapy Meetings of ASTCT and CIBMTR; February 19-23, 2020; Orlando, Florida. Abstract 32.
  34. Ponce DM, Nakamura R, Barker JN, et al. A phase 2 study of F-652, a novel tissue-targeted recombinant human interleukin-22 (IL-22) dimer, for treatment of newly diagnosed acute GVHD of the lower GI tract. Program and abstracts of the 2020 Transplant & Cellular Therapy Meetings of ASTCT and CIBMTR; February 19-23, 2020; Orlando, Florida. Abstract 68.
  35. Bejanyan N, Wang X, Nishihori T, et al. A phase II study of sirolimus-based calcineurin inhibitor-free GVHD prophylaxis after peripheral blood haploidentical transplantation with post-transplant cyclophosphamide. Program and abstracts of the 2020 Transplant & Cellular Therapy Meetings of ASTCT and CIBMTR; February 19-23, 2020; Orlando, Florida. Abstract 77.
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