Inpatient management of mucocutaneous GVHD Review
| Authors: | Vaidya, T. S.; Menzer, C.; Ponce, D. M.; Markova, A. |
| Review Title: | Inpatient management of mucocutaneous GVHD |
| Abstract: | Purpose of Review: Graft-versus-host disease (GVHD) is an immune mediated disorder affecting 30–70% of patients after allogeneic hematopoietic stem cell transplantation (alloHSCT), and is a major cause of morbidity and non-relapse mortality (NRM) as reported by Jagasia, et al. (Blood 119:296-307, •2012). Dermatologists play a critical role in acute and chronic GVHD, as skin involvement is common and often the earliest involved site of disease as reported by MacMillan, et al. (Biol Blood Marrow Transplant 21: 761-7, 2015). Recent Findings: GVHD shares clinical and histopathological features with a variety of other skin diseases, requiring thorough consideration of differential diagnoses in hematopoietic stem cell transplantation (HSCT) recipients with lesions suggestive of cutaneous GVHD. Treatment considerations for GVHD are influenced by factors such as disease classification, overall grading, organ involvement, associated symptoms, and immunological anti-tumor effect. Several treatments are available and may be indicated as monotherapy or adjuvant therapy to allow faster withdrawal or tapering of immunosuppression. While corticosteroids are often first-line therapy, oral ruxolitinib has been recently approved for treatment of steroid-refractory acute GVHD (aGVHD), and oral ibrutinib has been approved for steroid-refractory chronic GVHD (cGVHD). Summary: This article provides current clinical, diagnostic, and therapeutic considerations relevant to the hospitalist for both acute and chronic mucocutaneous GVHD. Optimal inpatient management of these diseases requires an interdisciplinary team. © 2019, Springer Science+Business Media, LLC, part of Springer Nature. |
| Keywords: | acute graft versus host disease; chronic graft versus host disease; gvhd; graft versus host disease; inpatient dermatology; dermatology hospitalist; inpatient management |
| Journal Title: | Current Dermatology Reports |
| Volume: | 8 |
| Issue: | 4 |
| ISSN: | 2162-4933 |
| Publisher: | Springer |
| Date Published: | 2019-12-01 |
| Start Page: | 258 |
| End Page: | 278 |
| Language: | English |
| DOI: | 10.1007/s13671-019-00280-3 |
| PROVIDER: | scopus |
| PMCID: | PMC7731642 |
| PUBMED: | 33312761 |
| DOI/URL: | |
| Notes: | Review -- Export Date: 2 January 2020 -- Source: Scopus |
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