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Author Notes:

Cristina Diaz-de-Heredia, Email: crdiaz@vhebron.net

MW provided content of critical importance, drafted the manuscript, and approved the final version. MQ, MB, TS, HB, and AL provided content of critical importance, revised the manuscript, and approved the final version. CD-d-H coordinated the writing process, provided content and structure of critical importance, revised the manuscript, and approved the final version. All authors contributed to the article and approved the submitted version.

Editorial support in the preparation of this manuscript was provided by Hannah Bridges of HB Health Comms Limited.

CD-d-H has acted as a consultant and speaker for and has received travel expenses from Novartis. MW has acted as a consultant for and has received travel expenses from Novartis. MW also received travel expenses from Mallinckrodt Pharmaceuticals. MQ received honoraria from Mesoblasts, Medexus, Jazz Pharmaceuticals, and Novartis. HB owns IP and receives royalties and licencing fees from Medac for an MSC product for aGvHD which he co-invented. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Subjects:

Research Funding:

This study received funding from the St. Anna Children's Cancer Research Institute, Vienna, Austria. The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Pediatrics
  • acute graft-versus-host disease (aGVHD)
  • management
  • hematopoietic (stem) cell transplantation
  • children
  • acute lymphoblastic leukaemia
  • STEROID-REFRACTORY ACUTE
  • BONE-MARROW-TRANSPLANTATION
  • MESENCHYMAL STROMAL CELLS
  • MINIMAL RESIDUAL DISEASE
  • CORD BLOOD TRANSPLANTS
  • TOTAL-BODY IRRADIATION
  • REGULATORY T-CELLS
  • HLA CLASS-I
  • EXTRACORPOREAL PHOTOPHERESIS
  • MYCOPHENOLATE-MOFETIL

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

Tools:

Journal Title:

FRONTIERS IN PEDIATRICS

Volume:

Volume 9

Publisher:

, Pages 784377-784377

Type of Work:

Article | Final Publisher PDF

Abstract:

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.

Copyright information:

© 2022 Wölfl, Qayed, Benitez Carabante, Sykora, Bonig, Lawitschka and Diaz-de-Heredia.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/rdf).
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