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After a donor transplant, the donor's immune cells may attack the patient's skin, gut and liver (graft-versus-host disease) while also hunting down leftover leukaemia (graft-versus-leukaemia). The two effects are linked, so doctors try to keep enough of the second without too much of the first.
Acute GVHD (first 100 days: rash, diarrhoea, jaundice) affects 30-50% of recipients; chronic GVHD (skin, mouth, eyes, lungs, joints) can last years and is the main cause of late morbidity. Prophylaxis uses calcineurin inhibitors, methotrexate, post-transplant cyclophosphamide or abatacept; treatment is steroids, then ruxolitinib (REACH2/3), belumosudil, axatilimab or ibrutinib for refractory disease. Donor lymphocyte infusions deliberately provoke graft-versus-leukaemia at relapse. Allogeneic CAR-T and NK products use gene editing or donor selection to avoid GVHD, and CRS is a different, cytokine-driven phenomenon.
Showing the molecule this term concerns: Ruxolitinib.
This is the trial behind belumosudil's July 2021 US approval for chronic graft-versus-host disease after two or more lines. For patients it means a once-daily pill with a high response rate in a condition where earlier treatments had failed; the FDA's own analysis, counting responses only through cycle 7 day 1, gave 75 percent.
This is the study behind the December 2024 US approval of remestemcel-L (Ryoncil), the first mesenchymal stromal cell therapy approved in the United States, for children whose acute graft-versus-host disease has not settled on steroids. The label reports the same 54 children as a 70 percent response.
Shares Remestemcel-L, A phase 3, single-arm, prospective study of remestemcel-L, ex vivo culture-expanded adult human mesenchymal stromal cells for the treatment of pediatric patients who failed to respond to steroid treatment for acute graft-versus-host disease, MSB-GVHD001.
Shares Extracorporeal photopheresis for graft-versus-host disease, Belumosudil, After ruxolitinib: belumosudil, axatilimab and ibrutinib in chronic GvHD, Preventing graft-versus-host disease, and what prevention costs.
Shares The lungs after transplant: bronchiolitis obliterans syndrome, Chronic GvHD organ by organ: skin, mouth, eyes, gut, liver, joints and genital tract, Conditioning regimen (myeloablative, reduced-intensity), After a transplant or cell therapy: what to ask for.
Shares Rebuilding an immune system: the timeline, lineage by lineage, Infection risk after transplant and cell therapy, phase by phase, and the prophylaxis that follows it, Revaccination after transplant: the schedules, and where the UK and the US differ, After a transplant or cell therapy: what to ask for.
Shares Rebuilding an immune system: the timeline, lineage by lineage, Infection risk after transplant and cell therapy, phase by phase, and the prophylaxis that follows it, After a transplant or cell therapy: what to ask for, Cytokine release syndrome (CRS).
Shares Chronic GvHD organ by organ: skin, mouth, eyes, gut, liver, joints and genital tract, Conditioning regimen (myeloablative, reduced-intensity), Chronic graft-versus-host disease, After a transplant or cell therapy: what to ask for.
Shares Rebuilding an immune system: the timeline, lineage by lineage, Infection risk after transplant and cell therapy, phase by phase, and the prophylaxis that follows it, Revaccination after transplant: the schedules, and where the UK and the US differ.
Shares Quality of life after transplant and cell therapy, Conditioning regimen (myeloablative, reduced-intensity), Chronic graft-versus-host disease, After a transplant or cell therapy: what to ask for.