Quelling an Internal Civil War: New and Emerging Treatments for Graft-vs-Host Disease

Target Audience
This educational activity has been designed for hematologists/oncologists, oncology and hematology fellows, and other members of the oncology care team who need to be aware of recent and emerging advances the prevention and treatment of GvHD.

Statement of Need/Program Overview
The leading cause of non-relapse post- allogeneic hematopoietic stem cell transplant mortality is GvHD manifesting as immunobiological warfare waged by the donor cells against multiple organ systems in the recipient. Approximately 50% of transplant patients die not from their hematologic disease, but from GvHD. Theories on the pathogenesis of GvHD are fraught with controversy. The complex pathobiological underpinnings of GvHD have not been thoroughly elucidated and more effective resolution of the disease has been impeded by lack of consensus on diagnostic biomarkers and staging system for determining response and prognosis. Treatment of GvHD after allo-HSCT now depends on achieving a therapeutic symmetry between steroids vs new and emerging agents with a variety of differing mechanisms of action. This educational activity will review and assess these treatment options and will raise clinicians’ level of awareness about the immunobiological signaling pathways involved in the pathophysiology of this disease as well as diagnostic and grading strategies.

Learning Objectives
Upon completion of this activity, participants should be able to:

-Characterize current knowledge about the biology and pathophysiology of GvHD
-Employ effective diagnostic and grading strategies for acute and chronic GvHD
-Elucidate still-evolving insights into the role of T- and B-cell signaling pathways in the development of GvL and GvHD
-Analyze currently approved and emerging agents to treat GvHD