A Biomarker-Guided Prophylaxis Strategy Reduces Acute GVHD

A randomized trial of 228 patients undergoing haploidentical HCT has demonstrated that low-dose corticosteroid prophylaxis administered to patients at high risk of developing acute graft-versus-host disease (GVHD) can significantly decrease the incidence of the disease. Researchers measured bone marrow allogeneic graft CD4:CD8 ratios, and used them to categorize patients as low risk (n=83) or high risk (n=145) to develop acute GVHD. High-risk patients were randomly assigned to either receive (n=72) or not receive (n=73) low-dose corticosteroid GVHD prophylaxis. The high-risk group that received corticosteroids had significantly lower acute GVHD compared to the high-risk control group: 21% vs. 48%, respectively (p<0.001). In an accompanying editorial, Dr. Edwin Alyea noted that this prophylactic strategy “spares those patients with a low risk of developing GVHD from being exposed to additional immunosuppressive agents.”

Chang Y-J, et al. J Clin Oncol

Related Resources