About cGVHD


Graft  versus  host  disease  is  caused  by  effector  lymphocytes  of  the  donor  reacting  against  specific  antigens  of  the patient. 

 

Acute  GVHD  (aGVHD)  is  characterized  by  marked  inflammation  of  the  affected  organs  and  tissues,  and  high- dose  immunosuppression  is  warranted  to  reverse  tissue  damage  and  initiate  the  regeneration  process.  Importantly, severe  aGVHD  is  an  independent  risk  factor  for  chronic  GVHD  (cGVHD). 

 

Chronic  GVHD  is  usually  more  indolent  in  its presentation,  resembles severe  autoimmune diseases  and, in  its most  severe  forms, leads  to  tissue  and  organ damage with marked fibrosis. Not only is this process in itself immunosuppressive with impairment of normal thymic function, the immunosuppressive  drugs  prescribed  to  reverse  the  manifestations  of  the  disease  and  promote  tissue  regeneration further  increase  the  risk  of  severe  infections  and  mortality. 

 

The  response  to  first-line  treatment  with  corticosteroids  is usually  modest,  and  less  than  50%  of  patients  have  adequate  tissue  regeneration  in  response  to  second-and  third-line line   treatments.   Due   to   permanent   organ   damage,   to   the   inability   to   regenerate   with   the   use   of   current immunosuppressive  treatments  and  the  inevitable  emergence  of  life-threatening  infections,  mortality  is  high  in  patients with intermediate and severe cGVHD.

 

There is clearly an unmet need for novel forms of treatment for both severe acute and chronic GVHD in order to regenerate normal organ function and decrease mortality.

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