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Thinking Out of the Box—New Approaches to Controlling GVHD

  • STEM CELL TRANSPLANTATION (R MAZIARZ, SECTION EDITOR)
  • Published:
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Abstract

Graft-versus-host disease (GVHD) remains a major limitation of allogeneic hematopoietic cell transplantation (allo-HCT). Despite major advances in the understanding of GVHD pathogenesis, standard GVHD prophylaxis regimens continue to be based on the combination of a calcineurin inhibitor with an antimetabolite, while first line treatments still rely on high-dose corticosteroids. Further, no second line treatment has emerged thus far in acute or chronic GVHD patients who failed to respond with corticosteroid treatment. After briefly reviewing current standards of GVHD prevention and treatment, this article will discuss recent approaches that might change GVHD prophylaxis/treatment for decades to come, with a special focus on recently developed immunoregulatory strategies based on infusion of mesenchymal stromal or regulatory T-cells, or injection of low-dose interleukin-2.

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Conflict of Interest

Dr. Frédéric Baron received a consulting fee or honorarium and support for travel to meetings from Genzyme/Sanofi.

Dr. Stéphanie Humblet-Baron, Dr. Grégory Ehx, Dr. Sophie Servais, Dr. Muriel Hannon, Dr. Ludovic Belle, Dr. Chantal Lechanteur, Dr. Alexandra Briquet, Dr. Olivier Gie, Dr. Etienne Baudoux and Dr. Evelyne Willems declare no potential conflicts of interest relevant to this article.

Dr. Yves Beguin received a grant from Milltenyi.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Grants

FB is Senior Research Associate, and GE and LB are Telivie PhD students at the National Fund for Scientific Research (FNRS) Belgium. SHB is postdoctoral researcher at the Fonds Wetenschappelijk Onderzoek—Vlaanderen (FWO). The review was in part supported by funds from the FNRS, the Belgian Foundation against Cancer (FBC), the anti-cancer foundation from the ULg, the Terry Fox foundation, and the plan cancer from the Belgian Government.

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  1. Department of Medicine, Division of Hematology, University and CHU of Liège, Liège, Belgium

    Frédéric Baron, Sophie Servais, Evelyne Willems & Yves Beguin

  2. GIGA I, University of Liège, Liège, Belgium

    Frédéric Baron, Stéphanie Humblet-Baron, Grégory Ehx, Sophie Servais, Muriel Hannon, Ludovic Belle & Yves Beguin

  3. Currently in autoimmune genetics laboratory, University of Leuven, Leuven, Belgium

    Stéphanie Humblet-Baron

  4. Laboratory of Cell and Genetic Therapy, University of Liège, Liège, Belgium

    Chantal Lechanteur, Alexandra Briquet, Olivier Giet & Etienne Baudoux

  5. Department of Hematology, University of Liège, CHU Sart-Tilman, 4000, Liège, Belgium

    Frédéric Baron

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Baron, F., Humblet-Baron, S., Ehx, G. et al. Thinking Out of the Box—New Approaches to Controlling GVHD. Curr Hematol Malig Rep 9, 73–84 (2014). https://doi.org/10.1007/s11899-013-0187-9

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