Paneth cells in gut GVHD: a Panglossian perspective.

摘要

Acute GVHD remains a major toxicity of allogeneic hematopoietic stem cell transplantation (HSCT) that is associated with significant nonrelapse mortality (NRM) and is clinically staged according to the severity of target organ involvement (skin, GI tract, liver). Visceral (GI, liver) involvement is a determinant of greater clinical GVHD severity and thus a worse prognosis. Importantly, acute GVHD outcomes are heterogeneous. Clinical factors for worse NRM and survival in acute GVHD include HLA-mismatch, older recipient age, unrelated donors, and GVHD clinical severity (grade 3-4), with the day 28 response to therapy an important additional prognosticator. To improve outcomes, the transplant community needs better diagnostic, prognostic, and therapeutic tools for high-risk GVHD patients earlier in their disease course.