National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2020 Etiology and Prevention Working Group Report

Kirsten M. Williams, Yoshihiro Inamoto, Annie Im, Betty Hamilton, John Koreth, Mukta Arora, Iskra Pusic, Jacqueline W. Mays, Paul A. Carpenter, Leo Luznik, Pavan Reddy, Jerome Ritz, Hildegard Greinix, Sophie Paczesny, Bruce R. Blazar, Joseph Pidala, Corey Cutler, Daniel Wolff, Kirk R. Schultz, Steven Z. PavleticStephanie J. Lee, Paul J. Martin, Gerard Socie, Stefanie Sarantopoulos

Research output: Contribution to journalReview articlepeer-review

Abstract

Preventing chronic graft-versus-host disease (GVHD) remains challenging because the unique cellular and molecular pathways that incite chronic GVHD are poorly understood. One major point of intervention for potential prevention of chronic GVHD occurs at the time of transplantation when acute donor anti-recipient immune responses first set the events in motion that result in chronic GVHD. After transplantation, additional insults causing tissue injury can incite aberrant immune responses and loss of tolerance, further contributing to chronic GVHD. Points of intervention are actively being identified so that chronic GVHD initiation pathways can be targeted without affecting immune function. The major objective in the field is to continue basic studies and to translate what is learned about etiopathology to develop targeted prevention strategies that decrease the risk of morbid chronic GVHD without increasing the risks of cancer relapse or infection. Development of strategies to predict the risk of developing debilitating or deadly chronic GVHD is a high research priority. This working group recommends further interrogation into the mechanisms underpinning chronic GVHD development, and we highlight considerations for future trial design in prevention trials.

Original languageEnglish (US)
Pages (from-to)452-466
Number of pages15
JournalTransplantation and Cellular Therapy
Volume27
Issue number6
DOIs
StatePublished - Jun 2021

ASJC Scopus subject areas

  • Hematology
  • Transplantation
  • Immunology and Allergy
  • Cell Biology
  • Molecular Medicine
  • Medicine(all)

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