EBMT 2018 | Salvage therapy for chronic GvHD: new approvals

Steven Pavletic

In this video, Steven Pavletic, MD, MS, from the National Cancer Institute, Bethesda, MD, speaks at the European Society for Blood and Marrow Transplantation (EBMT) 2018 Annual Meeting, held in Lisbon, Portugal, and outlines the salvage therapy options for steroid-refractory chronic graft-versus-host disease (GvHD).

Transcript (edited for clarity):

Once corticosteroids don’t work and patients fail in about 50% of cases unfortunately, then there is a long list of treatments that we use for salvage therapy. When speaking of systemic drugs for chronic graph versus host disease, and there are about 40 different drugs, most strategies how to treat systemically, most popular are extracorporeal photopheresis, sirolimus, mycophenolate, rituximab, imatinib, some other drugs recently there are some new treatments coming into the realm.
Recently we had the first-ever approval of a drug for chronic graft versus host disease, it’s ibrutinib, in the United States, the Food and Drug Administration granted approval to ibrutinib as a novel treatment for steroid refractive chronic graph versus host disease. At the end I would say there is always light at the end of the tunnel. It’s an unwanted, terrible complication when it occurs in our patients because at that point, they’re cured from leukemia and lymphoma, they have to suffer from these autoimmune diseases.
But in 90% of cases, it goes away within 3 to 5 years, patients go most of the time, back to their normal functional status once chronic GvHD is resolved, and what we have to do is not forget and to do regular long-term follow-up for late effects because there’s always at high risk of late complications like second malignancies, cataracts, osteoporosis, infertility and other problems, so we have to just stay in contact them for health care and maintenance throughout their lives.

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