In this review, the authors summarize the current preclinical studies and early-phase clinical trial results on the following new chronic graft-versus-host disease (GVHD) therapeutic techniques. Many of these new approaches target specific immunologic pathways now known to play a role in chronic GVHD. The discussion includes their potential clinical applications by technique:
- Depletion of alloreactive T cells for chronic GVHD prevention
- B-cell depletion for established chronic GVHD
- B-cell depletion for chronic GVHD prevention
- Targeting the B-cell receptor signaling pathway
- Prevention of B-cell development
- Inhibition of cytokine receptor-mediated signaling
- Facilitating Treg reconstitution for chronic GVHD prevention
- Adoptive Treg-cell therapy
- Enhancement of CD4 Tregs in vivo
The authors conclude that “as these agents undergo clinical evaluation, by themselves and in combination, it seems likely that more effective and less toxic therapies will soon be available for the prevention and treatment of chronic GVHD.”