Journal
BLOOD
Volume 127, Issue 12, Pages 1544-1550Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2015-10-612747
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Treatment of acute graft-versus-host disease (GVHD) has evolved from a one-size-fits-all approach to a more nuanced strategy based on predicted outcomes. Lower and time-limited doses of immune suppression for patients predicted to have low-risk GVHD are safe and effective. In more severe GVHD, prolonged exposure to immunosuppressive therapies, failure to achieve tolerance, and inadequate clinical responses are the proximate causes of GVHD-related deaths. This article presents acute GVHD-related scenarios representing, respectively, certainty of diagnosis, multiple causes of symptoms, jaundice, an initial therapyalgorithm, secondary therapy, and defining futility of treatment.
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