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Acute Graft Versus Host Disease: A Comprehensive Review.

Abstract Acute graft versus host disease (aGVHD) remains the second leading cause of death following allogeneic hematopoietic stem cell transplant (AHSCT). Over the last five years, the progress in understanding the pathophysiology of this immune based-process helped redefine graft versus host reaction and opened new possibilities for novel preventive and therapeutic approaches. The evolution in the field of immunology widened the horizons for hematopoietic stem cell transplant leading to the availability of different stem cell sources for potential graft and incorporation of novel conditioning regimens. There is conflicting data about the impact of the graft source and the conditioning regimen used in the process of AHSCT on the incidence of aGVHD. Many studies have reported increased risk of chronic GVHD (cGVHD) and to a less extent aGVHD with the use of peripheral blood stem cell and bone marrow compared to umbilical cord stem cell. The conditioning regimen, either myeloablative, non-myeloablative or reduced intensity may have different impact on the incidence of GVHD. Several preventive modalities have been adopted by different transplant centers but, to date, there is no standardized regimen. As for treatment, immunosuppression using steroids remains the first line of intervention. Several novel therapeutic options are being investigated for treatment of steroid-refractory aGVHD including the use of mesenchymal stem cells, anti thymocyte globulin and extra corporeal photophoresis. This review discusses the pathophysiology, risk factors, clinical features, and advances in the diagnosis, prevention and treatment of aGVHD.
PMID
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Authors

Mayor MeshTerms
Keywords

Acute graft versus host disease

allogeneic hematopoietic stem cell transplantation

bone marrow transplantation

leukemia

review

Journal Title anticancer research
Publication Year Start




PMID- 28373413
OWN - NLM
STAT- MEDLINE
DA  - 20170404
DCOM- 20170413
LR  - 20170413
IS  - 1791-7530 (Electronic)
IS  - 0250-7005 (Linking)
VI  - 37
IP  - 4
DP  - 2017 Apr
TI  - Acute Graft Versus Host Disease: A Comprehensive Review.
PG  - 1547-1555
AB  - Acute graft versus host disease (aGVHD) remains the second leading cause of death
      following allogeneic hematopoietic stem cell transplant (AHSCT). Over the last
      five years, the progress in understanding the pathophysiology of this immune
      based-process helped redefine graft versus host reaction and opened new
      possibilities for novel preventive and therapeutic approaches. The evolution in
      the field of immunology widened the horizons for hematopoietic stem cell
      transplant leading to the availability of different stem cell sources for
      potential graft and incorporation of novel conditioning regimens. There is
      conflicting data about the impact of the graft source and the conditioning
      regimen used in the process of AHSCT on the incidence of aGVHD. Many studies have
      reported increased risk of chronic GVHD (cGVHD) and to a less extent aGVHD with
      the use of peripheral blood stem cell and bone marrow compared to umbilical cord 
      stem cell. The conditioning regimen, either myeloablative, non-myeloablative or
      reduced intensity may have different impact on the incidence of GVHD. Several
      preventive modalities have been adopted by different transplant centers but, to
      date, there is no standardized regimen. As for treatment, immunosuppression using
      steroids remains the first line of intervention. Several novel therapeutic
      options are being investigated for treatment of steroid-refractory aGVHD
      including the use of mesenchymal stem cells, anti thymocyte globulin and extra
      corporeal photophoresis. This review discusses the pathophysiology, risk factors,
      clinical features, and advances in the diagnosis, prevention and treatment of
      aGVHD.
CI  - Copyright(c) 2017, International Institute of Anticancer Research (Dr. George J. 
      Delinasios), All rights reserved.
FAU - Nassereddine, Samah
AU  - Nassereddine S
AD  - Department of Internal Medicine, George Washington University School of Medicine 
      and Health Sciences, Washington DC, U.S.A.
FAU - Rafei, Hind
AU  - Rafei H
AD  - Department of Internal Medicine, George Washington University School of Medicine 
      and Health Sciences, Washington DC, U.S.A.
FAU - Elbahesh, Ehab
AU  - Elbahesh E
AD  - Clearview Cancer Institute, Huntsville, AL, U.S.A.
FAU - Tabbara, Imad
AU  - Tabbara I
AD  - Division of Hematology/Oncology and GW Cancer Center, George Washington
      University Medical Faculty Associates, Washington DC, U.S.A.
      [email protected]
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Greece
TA  - Anticancer Res
JT  - Anticancer research
JID - 8102988
SB  - IM
MH  - Acute Disease
MH  - Graft vs Host Disease/*diagnosis/*prevention & control
MH  - Humans
OTO - NOTNLM
OT  - *Acute graft versus host disease
OT  - *allogeneic hematopoietic stem cell transplantation
OT  - *bone marrow transplantation
OT  - *leukemia
OT  - *review
EDAT- 2017/04/05 06:00
MHDA- 2017/04/14 06:00
CRDT- 2017/04/05 06:00
PHST- 2017/02/11 [received]
PHST- 2017/03/03 [revised]
PHST- 2017/03/07 [accepted]
AID - 37/4/1547 [pii]
AID - 10.21873/anticanres.11483 [doi]
PST - ppublish
SO  - Anticancer Res. 2017 Apr;37(4):1547-1555.

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