2025 Volume 14 Issue 3 Pages 114-120
Stable long-term control of GVHD after allogeneic hematopoietic stem cell transplantation is one of the key challenges in an era of increasingly diverse transplant modalities. Over the past decade, the development of objective criteria for the diagnosis and evaluation of GVHD and advances in our understanding of the biological pathways of GVHD pathogenesis have led to steady progress in the development of novel agents. Until recently, calcineurin inhibitors and steroids have dominated the management of GVHD in transplantation, however, in recent years, T-cell depletion therapy to limit donor T-cell proliferation in the acute phase and the patient-oriented target therapy to minimize steroid exposure and suppress the specific pathogenesis are being considered. The development and clinical implementation of biomarkers to identify pathologic pathways in individual patients will be the basis for appropriate post-transplant immune management. The establishment of the clinical approach based on objective information will greatly accelerate the trend toward personalized medicine in immune managements, leading to safe and long survival with satisfactory QOL.
