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Home > About GvHD

Are your allogeneic hematopoietic stem cell transplant (alloHSCT) patients at risk?

GvHD is a common and potentially deadly complication of alloHSCT1

  • ~25,000 alloHSCT procedures are carried out worldwide and the number continues to grow2,3
Serious consequences of aGvHD

Symptoms of aGvHD include6:

Symptoms of aGvHD
alloHSCT, allogeneic hematopoietic stem cell transplant; GI, gastrointestinal; GvHD, graft-versus-host disease; OS, overall survival.

In-hospital mortality is 3x higher for alloHSCT patients who develop aGvHD4

Survival rates are halved for patients with steroid-refractory disease7

Survival Rates for GvHD patients

Historically, there has been no consensus regarding treatment approach for refractory patients with reduced survival8

~50% of patients with aGvHD become steroid-refractory7,9

Definition of steroid-resistant aGvHD
CIBMTR, Center for International Blood and Marrow Transplant Research; EBMT, European Society for Blood and Marrow Transplantation; NIH, National Institutes of Health.

Failing to respond to first-line therapy more than doubles GvHD mortality rates7


At the first sign of steroid failure, choose JAKAVI11

Prior aGvHD is the main predictor of progression to chronic disease12-14

59-85% of patients with grade II-IV aGvHD progress to cGvHD

A majority of patients with cGvHD have a prior history of aGvHD12-14

Chronic disease can develop in three ways12-14

Chronic GvHD develops in three ways

Distinctions between acute and chronic disease are poorly defined in some patients who may present with elements of each, known as “chronic overlap syndrome”6,16

  1. Zeiser R, Blazar BR. Acute graft-versus-host disease - biology, prevention and therapy. N Engl J Med. 2017;377(22):2167-2179.
  2. D’Souza A, Lee S, Zhu X, Pasquini M. Current use and trends in hematopoietic cell transplantation in the United States. Biol Blood Marrow Transplant. 2017;23(9):1417-1421.
  3. Passweg JR, Baldomero H, Bader P, et al; European Society for Blood and Marrow Transplantation (EBMT). Is the use of unrelated donor transplantation leveling off in Europe? The 2016 European Society for Blood and Marrow Transplant activity survey report. Bone Marrow Transplant. 2018;53(9):1139-1148.
  4. Yu J, Parasuraman S, Shah A, Weisdorf D. Mortality, length of stay and costs associated with acute graft-versus-host disease during hospitalization for allogeneic hematopoietic stem cell transplantation. Curr Med Res Opin. 2019;35(6):983-988.
  5. Miller HK, Braun TM, Stillwell T, et al. Infectious risk after allogeneic hematopoietic cell transplantation complicated by acute graft-versus-host disease. Biol Blood Marrow Transplant. 2017;23(3):522-528.
  6. Ferrara JL, Levine JE, Reddy P, Holler E. Graft-versus-host disease. Lancet. 2009;373(9674):1550-61.
  7. Westin JR, Saliba RM, De Lima M, et al. Steroid-refractory acute GvHD: predictors and outcomes. Adv Hematol. 2011;2011:601953.
  8. Zeiser R, von Bubnoff N, Butler J, et al; REACH2 Trial Group. Ruxolitinib for glucocorticoid-refractory acute graft-versus-host disease. N Engl J Med. 2020;382(19):1800-1810.
  9. MacMillan ML, Weisdorf DJ, Wagner JE, et al. Response of 443 Patients to Steroids as Primary Therapy for Acute Graft-Versus-Host Disease: Comparison of Grading Systems. Biol Blood Marrow Transplant. 2002;8:387–394.
  10. Schoemans HM, Lee SJ, Ferrara JL, et al; EBMT (European Society for Blood and Marrow Transplantation) Transplant Complications Working Party and the “EBMT−NIH (National Institutes of Health)−CIBMTR (Center for International Blood and Marrow Transplant Research) GvHD Task Force.” EBMT-NIH-CIBMTR Task Force position statement on standardized terminology & guidance for graft-versus-host disease assessment. Bone Marrow Transplant. 2018;53(11):1401-1415.
  11. JAKAVI® (ruxolitinib) tablets: EU Summary of Product Characteristics. Novartis; January 2022.
  12. Pidala J, Kim J, Anasetti C, et al. The global severity of chronic graft-versus-host disease, determined by National Institutes of Health consensus criteria, is associated with overall survival and non-relapse mortality. Haematologica. 2011;96(11):1678-1684.
  13. Pavletic SZ, Smith LM, Bishop MR, et al. Prognostic factors of chronic graft-versus-host disease after allogeneic blood stem-cell transplantation. Am J Hematol. 2005;78(4):265-74.
  14. Grube M, Holler E, Weber D, Holler B, Herr W, Wolff D. Risk factors and outcome of chronic graft-versus-host disease after allogeneic stem cell transplantation—results from a single-center observational study. Biol Blood Marrow Transplant. 2016;22(10):1781-1791.
  15. Ratanatharathorn V, Ayash L, Lazarus HM, Fu J, Uberti JP. Chronic graft-versus-host disease: clinical manifestation and therapy. Bone Marrow Transplant. 2001;28(2):121-9.
  16. Lee SJ. Classification systems for chronic graft-versus-host disease. Blood. 2017;129(1):30-37.