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Current Prophylaxis and Treatment Approaches for Acute Graft-Versus-Host Disease in Haematopoietic Stem Cell Transplantation for Children With Acute Lymphoblastic Leukaemia

Acute graft-versus-host disease (aGvHD) continues to be a leading cause of morbidity and mortality following allogeneic haematopoietic stem cell transplantation (HSCT). However, higher event-free survival (EFS) was observed in patients with acute lymphoblastic leukaemia (ALL) and grade II aGvHD vs....

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Autores principales: Wölfl, Matthias, Qayed, Muna, Benitez Carabante, Maria Isabel, Sykora, Tomas, Bonig, Halvard, Lawitschka, Anita, Diaz-de-Heredia, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771910/
https://www.ncbi.nlm.nih.gov/pubmed/35071133
http://dx.doi.org/10.3389/fped.2021.784377
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author Wölfl, Matthias
Qayed, Muna
Benitez Carabante, Maria Isabel
Sykora, Tomas
Bonig, Halvard
Lawitschka, Anita
Diaz-de-Heredia, Cristina
author_facet Wölfl, Matthias
Qayed, Muna
Benitez Carabante, Maria Isabel
Sykora, Tomas
Bonig, Halvard
Lawitschka, Anita
Diaz-de-Heredia, Cristina
author_sort Wölfl, Matthias
collection PubMed
description Acute graft-versus-host disease (aGvHD) continues to be a leading cause of morbidity and mortality following allogeneic haematopoietic stem cell transplantation (HSCT). However, higher event-free survival (EFS) was observed in patients with acute lymphoblastic leukaemia (ALL) and grade II aGvHD vs. patients with no or grade I GvHD in the randomised, controlled, open-label, international, multicentre Phase III For Omitting Radiation Under Majority age (FORUM) trial. This finding suggests that moderate-severity aGvHD is associated with a graft-versus-leukaemia effect which protects against leukaemia recurrence. In order to optimise the benefits of HSCT for leukaemia patients, reduction of non-relapse mortality—which is predominantly caused by severe GvHD—is of utmost importance. Herein, we review contemporary prophylaxis and treatment options for aGvHD in children with ALL and the key challenges of aGvHD management, focusing on maintaining the graft-versus-leukaemia effect without increasing the severity of GvHD.
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spelling pubmed-87719102022-01-21 Current Prophylaxis and Treatment Approaches for Acute Graft-Versus-Host Disease in Haematopoietic Stem Cell Transplantation for Children With Acute Lymphoblastic Leukaemia Wölfl, Matthias Qayed, Muna Benitez Carabante, Maria Isabel Sykora, Tomas Bonig, Halvard Lawitschka, Anita Diaz-de-Heredia, Cristina Front Pediatr Pediatrics Acute graft-versus-host disease (aGvHD) continues to be a leading cause of morbidity and mortality following allogeneic haematopoietic stem cell transplantation (HSCT). However, higher event-free survival (EFS) was observed in patients with acute lymphoblastic leukaemia (ALL) and grade II aGvHD vs. patients with no or grade I GvHD in the randomised, controlled, open-label, international, multicentre Phase III For Omitting Radiation Under Majority age (FORUM) trial. This finding suggests that moderate-severity aGvHD is associated with a graft-versus-leukaemia effect which protects against leukaemia recurrence. In order to optimise the benefits of HSCT for leukaemia patients, reduction of non-relapse mortality—which is predominantly caused by severe GvHD—is of utmost importance. Herein, we review contemporary prophylaxis and treatment options for aGvHD in children with ALL and the key challenges of aGvHD management, focusing on maintaining the graft-versus-leukaemia effect without increasing the severity of GvHD. Frontiers Media S.A. 2022-01-06 /pmc/articles/PMC8771910/ /pubmed/35071133 http://dx.doi.org/10.3389/fped.2021.784377 Text en Copyright © 2022 Wölfl, Qayed, Benitez Carabante, Sykora, Bonig, Lawitschka and Diaz-de-Heredia. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Wölfl, Matthias
Qayed, Muna
Benitez Carabante, Maria Isabel
Sykora, Tomas
Bonig, Halvard
Lawitschka, Anita
Diaz-de-Heredia, Cristina
Current Prophylaxis and Treatment Approaches for Acute Graft-Versus-Host Disease in Haematopoietic Stem Cell Transplantation for Children With Acute Lymphoblastic Leukaemia
title Current Prophylaxis and Treatment Approaches for Acute Graft-Versus-Host Disease in Haematopoietic Stem Cell Transplantation for Children With Acute Lymphoblastic Leukaemia
title_full Current Prophylaxis and Treatment Approaches for Acute Graft-Versus-Host Disease in Haematopoietic Stem Cell Transplantation for Children With Acute Lymphoblastic Leukaemia
title_fullStr Current Prophylaxis and Treatment Approaches for Acute Graft-Versus-Host Disease in Haematopoietic Stem Cell Transplantation for Children With Acute Lymphoblastic Leukaemia
title_full_unstemmed Current Prophylaxis and Treatment Approaches for Acute Graft-Versus-Host Disease in Haematopoietic Stem Cell Transplantation for Children With Acute Lymphoblastic Leukaemia
title_short Current Prophylaxis and Treatment Approaches for Acute Graft-Versus-Host Disease in Haematopoietic Stem Cell Transplantation for Children With Acute Lymphoblastic Leukaemia
title_sort current prophylaxis and treatment approaches for acute graft-versus-host disease in haematopoietic stem cell transplantation for children with acute lymphoblastic leukaemia
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771910/
https://www.ncbi.nlm.nih.gov/pubmed/35071133
http://dx.doi.org/10.3389/fped.2021.784377
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