GvHD Hub

The GvHD Hub was pleased to speak to Andrew Gennery, Newcastle University and Great North Children’s Hospital, Newcastle upon Tyne, UK, and Chair of the UK Photopheresis Society, about the future directions of extracorporeal photopheresis (ECP) for the treatment of graft-versus-host disease (GvHD).View on the GvHD Hub here: https://gvhdhub.com/medical-information/future-perspectives-of-ecp-for-gvhd-treatmentGennery begins by providing a background to using ECP in pediatric patients, including the potential complications involved and how to mitigate these. He then discusses the process of ECP, including treatment scheduling, and its efficacy in different types of GvHD. Gennery goes on to speak about how the treatment landscape for GvHD has changed in the last 5 years, how it might change in the future, and where ECP fits in as an immunomodulatory agent. In the future, ECP may be combined with the newer immunosuppressive agents that are approved, or in development, for the treatment of GvHD to deliver positive outcomes for patients.This independent educational activity was supported by Mallinckrodt Pharmaceuticals. All content was developed independently by the faculty. The funder was allowed no influence on the content of this activity. 

On April 14, 2024, the GvHD Hub held a symposium at the 50th European Society for Bone and Marrow Transplantation (EBMT) Annual Meeting on the role of extracorporeal photopheresis (ECP) in the management of chronic graft-versus-host disease (cGvHD).Zinaida Perić, University of Rijeka, Rijeka, HR, shared her thoughts on patient eligibility, treatment optimization, and follow-up after treatment with ECP for cGvHD. She also discussed a case report of a patient with steroid-refractory (SR)-cGvHD, plus retrospective and prospective data on the use of ECP in cGvHD. In addition, she shared the Nordic ECP Quality Group treatment guidelines for SR-cGvHD.

On April 14, 2024, the GvHD Hub held a symposium at the 50th European Society for Bone and Marrow Transplantation (EBMT) Annual Meeting on the role of extracorporeal photopheresis (ECP) in the management of chronic graft-versus-host disease (cGvHD). Here, we share the presentation by Florent Malard, Hôpital Saint-Antoine and Sorbonne Université, Paris, FR, that explored early intervention and ECP-based combinations. Mallard covered use of ECP first-line, as well as ECP combinations in patients with steroid-refractory and steroid-dependent cGvHD, including recent approvals and findings from clinical trials.

On April 14, 2024, the GvHD Hub held a symposium at the 50th European Society for Bone and Marrow Transplantation (EBMT) Annual Meeting on the role of extracorporeal photopheresis (ECP) in the management of chronic graft-versus-host disease (cGvHD).  Here, we share the presentation by Bipin Savani, Vanderbilt University Medical Center, Nashville, US, which explored the long-term burden of cGvHD. Savani discussed organs frequently affected by cGvHD, comorbidities and mortality in patients with cGvHD, and recent progress made in improving the safety of transplantation. He highlighted that mental health disorders, such as anxiety and depression, are prevalent in patients with cGvHD and that the physical burden of symptomscontributes to limitation of daily activities in these patients. 

During the GvHD Hub Steering Committee meeting in November 2022, key opinion leaders met to discuss what supportive care should look like for patients with chronic graft-versus-host disease (GvHD). The recorded discussion was chaired by Professor Amin Alousi (University of Texas MD Anderson Cancer Centre, Houston, US) and featured Mutlu Arat (Istanbul Florence Nightingale Hospital, Istanbul, TR), Ali Bazarbachi (American University of Beirut, Beirut, LB), Hildegard Greinix (Medical University of Graz, Graz, AT), and Attilio Olivieri (Ospedali Riuniti di Ancona, Ancona, IT).Professor Alousi opens by highlighting the importance of supportive care in GvHD and the challenges in ensuring this is delivered effectively. This discussion focusses on the side effects and adverse events associated with GvHD treatments, including those that may have a negative impact on a patient’s quality of life. The steering committee members discuss the need for a multidisciplinary approach to GvHD treatment through communication with other healthcare professionals (HCPs). For example, mental health professionals, pharmacists, and ophthalmologists may all be involved in the treatment of a patient with GvHD depending on the manifestation of the disease. The discussion concludes that cross-functional collaboration of HCPs may have a positive impact on quality of life and requires further research.

During the 2022 Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR (Tandem Meetings), the GvHD Hub was pleased to speak to Gérard Socié, Hôpital Saint-Louis, Paris, FR. We asked, How would you treat acute GvHD (aGvHD) in your clinic (an EU perspective)?Socié begins by highlighting the main differences between aGvHD treatment in the EU and in the US. Socié then discusses the use of steroids in aGvHD treatment, despite 40–50% of patients becoming steroid-resistant. Finally, Socié talks about the current standard of care in steroid-resistant aGvHD.

During the 48th Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), the GvHD Hub was pleased to speak to Zinaida Perić, University of Zagreb, Zagreb, HR, and Bipin Savani, Vanderbilt University Medical Center, Nashville, US. We asked, What should supportive care look like for patients with GvHD? What role does physical activity play in these patients? Savani begins by highlighting the importance of supportive care for patients with GvHD. Perić then discusses how, if local therapy is effective enough, systemic treatment can be avoided, and how there should always be an aim to use the least immunosuppression possible. Savani goes on to talk about pain and fatigue management in these patients and how physical therapy could play a role. Finally, both Perić and Savani emphasize that supportive care should be a priority, and more data on the use of physical exercise and therapy is key to improving the quality of life for patients with GvHD.

During the 48th Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), the GvHD Hub was pleased to speak to Daniel Weisdorf, University of Minnesota, Minneapolis, US. We asked, How do we stratify risk in patients with GvHD? Weisdorf begins by discussing the Minnesota Risk Score (M. MacMillan, et al.), which uses the stage of skin, liver, and gut involvement in GvHD to predict the response to therapy. Weisdorf then talks about the potential of incorporating biomarkers into the Minnesota Risk Score in the future.