Clinical and molecular landscapes of steroid-refractory graft-versus-host disease following hematopoietic stem cell transplantation: a narrative review DOI
Thomas S. Gunning,

Jack Cucchiara,

Elahe Golalipour

и другие.

Regenerative medicine reports ., Год журнала: 2025, Номер 2(2), С. 53 - 60

Опубликована: Апрель 8, 2025

Allogeneic hematopoietic stem cell transplantation is a highly effective cell-based therapy, but graft-versus-host disease remains major post-transplant complication. While first-line treatment involves high-dose corticosteroids, up to half of patients go on develop steroid-refractory disease, where symptoms persist or worsen despite steroid treatment. This review provides an update the clinical and molecular landscapes examining challenges in diagnosis, management, general understanding pathophysiology. Progression confers poor prognosis associated with increased morbidity. There are multiple mechanisms that drive which include overactivation T-cell B-cell mechanisms, heightened inflammatory state, cell-intrinsic factors mediate responses. Current options beyond corticosteroids JAK pathway inhibition, mesenchymal extracorporeal photopheresis, additional therapies currently under investigation trials. Potential avenues for future directions must aim improve patient outcomes survivorship. Through comprehensive elucidation underlying development mechanism-based, regenerative medicine-targeted therapeutic strategies, optimization trial design, it anticipated quality life will be significantly improved. From standpoint, these advancements expected catalyze transition from empirical more personalized, mechanism-directed therapies, ultimately providing durable disease.

Язык: Английский

Clinical and molecular landscapes of steroid-refractory graft-versus-host disease following hematopoietic stem cell transplantation: a narrative review DOI
Thomas S. Gunning,

Jack Cucchiara,

Elahe Golalipour

и другие.

Regenerative medicine reports ., Год журнала: 2025, Номер 2(2), С. 53 - 60

Опубликована: Апрель 8, 2025

Allogeneic hematopoietic stem cell transplantation is a highly effective cell-based therapy, but graft-versus-host disease remains major post-transplant complication. While first-line treatment involves high-dose corticosteroids, up to half of patients go on develop steroid-refractory disease, where symptoms persist or worsen despite steroid treatment. This review provides an update the clinical and molecular landscapes examining challenges in diagnosis, management, general understanding pathophysiology. Progression confers poor prognosis associated with increased morbidity. There are multiple mechanisms that drive which include overactivation T-cell B-cell mechanisms, heightened inflammatory state, cell-intrinsic factors mediate responses. Current options beyond corticosteroids JAK pathway inhibition, mesenchymal extracorporeal photopheresis, additional therapies currently under investigation trials. Potential avenues for future directions must aim improve patient outcomes survivorship. Through comprehensive elucidation underlying development mechanism-based, regenerative medicine-targeted therapeutic strategies, optimization trial design, it anticipated quality life will be significantly improved. From standpoint, these advancements expected catalyze transition from empirical more personalized, mechanism-directed therapies, ultimately providing durable disease.

Язык: Английский

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