The Strategies for the Prevention of Chronic GVHD in Hematopoietic Stem Cell Transplantation

ABSTRACT

Chronic graft-versus-host disease (GVHD) is the most frequent late complication after hematopoietic cell transplantation and has a major impact on the quality of life and survival. As the pathophysiology of GVHD is still incompletely understood, it has been difficult to design effective prophylactic regimens. However, prevention of acute GVHD appears to result in a lower incidence of chronic GVHD. The use of younger, non-allo-sensitized donors, preferentially of the same sex as the patient, and the use of stem cells other than G-CSF-mobilized peripheral blood stem cells, are associated with a decreased frequency of chronic GVHD. Further, the incorporation of thymoglobulin into the conditioning regimen has been demonstrated as beneficial to reduce chronic GVHD and delayed complications.