Arora Mukta
Division of Hematology, Oncology and Transplantation, University of Minnesota, Mayo Mail Code 480, 420 Delaware Street SE, Minneapolis MN 55455, USA.
Best Pract Res Clin Haematol. 2008 Jun;21(2):271-9. doi: 10.1016/j.beha.2008.02.015.
Chronic graft-versus-host disease (cGVHD) is a common complication after hematopoietic-cell transplant and remains the leading cause of late non-relapse mortality. Standard treatment includes a combination of a calcineurin inhibitor and corticosteroids. Prolonged steroid use is required, with more than 50% of patients continuing immunosuppression beyond 2 years. There is no standard second-line therapy for cGVHD. Many agents have been reported in small case series, but the studies are heterogeneous in patient selection and response criteria. There is a need for a systematic study of agents for secondary therapy of cGVHD. In addition, both cGVHD and its treatment are associated with severe complications, including life-threatening infections, reduced quality of life, and psychosocial disturbances. A multidisciplinary approach to evaluating and managing patients with cGVHD is preferred, and disciplined, prospective study of new therapies is essential to make further progress in its understanding and treatment.
慢性移植物抗宿主病（cGVHD）是造血细胞移植后的常见并发症，仍是晚期非复发死亡的主要原因。标准治疗包括钙调神经磷酸酶抑制剂和皮质类固醇的联合使用。需要长期使用类固醇，超过50%的患者在2年以上仍持续接受免疫抑制治疗。对于cGVHD尚无标准的二线治疗方法。在小型病例系列中已报道了许多药物，但这些研究在患者选择和反应标准方面存在异质性。有必要对cGVHD二线治疗药物进行系统研究。此外，cGVHD及其治疗均与严重并发症相关，包括危及生命的感染、生活质量下降和心理社会障碍。评估和管理cGVHD患者首选多学科方法，对新疗法进行严谨、前瞻性研究对于在其认识和治疗方面取得进一步进展至关重要。
