Chronic GvHD NIH Consensus Project Biology Task Force: evolving path to personalized treatment of chronic GvHD

Abstract

Chronic GvHD (cGvHD) remains a prominent barrier to allogeneic hematopoietic stem cell transplantion as the leading cause of non-relapse mortality and significant morbidity. Tremendous progress has been achieved in both understanding of pathophysiology and the development of new therapies for cGvHD. While our field has historically approached treatment from an empiric position, research performed at the bedside and bench has elucidated some of the complex pathophysiology of cGvHD. From the clinical perspective, there is significant variability of disease manifestations between individual patients, pointing to diverse biological underpinnings. Capitalizing on progress made to date, the field is now focused on establishing personalized treatment approaches. The manuscript's intent is to concisely review recent knowledge gained and formulate a path towards patient-specific cGvHD therapy.

Recent advances in ocular graft-versus-host disease

“…In particular, it was found that IL-1, IL-2, IL-6, IL-8, IL-10, IL-17, IP-10/CXCL-10, ICAM-1, TNF-a, EGF, lymphotoxina(LT-a), E-selectin (CD62E), B-cell activation factor (BAFF), and neuropilin-1 could be regarded as biomarkers of ocular GVHD for prediction, diagnosis, and prognosis (139,142,145,(150)(151)(152). In addition to their clinical utility, these biomarkers can identify potential therapeutic mechanisms and biological targets (153). For prediction, Cocho et al (143) generated predictive models based on the best panel of IL-8/CXCL8 and IP-10/CXCL10 tear levels along with age and sex, which showed good sensitivity (86.36%) and specificity (95.24%).…”

Red cell distribution width as a new prognostic biomarker in refractory chronic graft-versus-host disease

“…3,4 Despite significant progress in the classifications of cGvHD, there is a need for improved and practical prognostication systems to address interpatient variability and achieve the goal of personalized treatment. 5 In this study, we introduce red cell distribution width (RDW) as a new biomarker candidate that could enhance the development of personalized treatment strategies and risk stratifications for cGvHD. Red cell distribution width is a measure of the variation of the mean corpuscular volume of red blood cells (RBC) and is routinely reported in most standard complete blood count results.…”