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Chronic graft‐versus‐host disease: Current management paradigm and future perspectives
Author(s) -
Mawardi Hani,
Hashmi Shahrukh K.,
Elad Sharon,
Aljurf Mahmoud,
Treister Nathaniel
Publication year - 2019
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/odi.12936
Subject(s) - medicine , disease , graft versus host disease , intensive care medicine , transplantation , hematopoietic stem cell transplantation , immunology , pathology , surgery
The field of allogeneic hematopoietic cell transplantation (allo‐HCT) began in the 1950s, and despite a seven decade history of remarkable clinical advances, graft‐versus‐host‐disease (GVHD) remains the greatest obstacle in its success due to considerable morbidity and mortality. Graft‐versus‐host disease is the second leading cause of transplantation‐related mortality (TRM) after relapse of primary disease. There are two main types of GVHD—acute and chronic—differing in the pathogenesis, time of onset, and clinical presentation. Objective This review provides a comprehensive overview of chronic GVHD pathophysiology and current management paradigms, as well as consideration of promising novel therapies. Conclusion Chronic GVHD is a serious disease which may be active for years, or even decades, requiring potentially years of immunosuppressive therapies and placing patients at risk for a number of late complications. While the oral cavity has long been recognized to be a prominent target of GVHD, and in particular, chronic GVHD, it must be recognized and appreciated that it is a complex systemic disease with a wide spectrum of clinical manifestations.