Chronic graft-versus-host disease (GVHD) in children

Pediatr Clin North Am. 2010 Feb;57(1):297-322. doi: 10.1016/j.pcl.2009.11.003.

Abstract

Five-year survival rates for childhood cancer now exceed 80% and with the significant progress made by the transplant community in developing less toxic conditioning regimens and in the treatment of posttransplant complications, allo-hematopoietic stem cell transplantation (HSCT) contributes significantly to that population of long-term survivors. In this context, the acute and long-term toxicities of chronic graft-versus-host disease (cGVHD) have an ever-increasing effect on organ function, quality of life, and survival; patients and families who initially felt great relief to be cured from the primary disease, now face the challenge of a chronic debilitating illness for which preventative and treatment strategies are suboptimal. Hence, the development of novel strategies that reduce and or control cGVHD, preserve graft-versus-tumor effects, facilitate engraftment and immune reconstitution, and enhance survival after allo-HSCT represents one of the most significant challenges facing physician-scientists and patients.

Publication types

  • Review

MeSH terms

  • Child
  • Chronic Disease
  • Glucocorticoids / therapeutic use
  • Graft vs Host Disease* / drug therapy
  • Graft vs Host Disease* / etiology
  • Graft vs Host Disease* / mortality
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Immunosuppression Therapy / methods*
  • Immunosuppressive Agents / therapeutic use
  • Prognosis
  • Survival Rate / trends
  • Transplantation, Homologous / adverse effects

Substances

  • Glucocorticoids
  • Immunosuppressive Agents