Chronic GvHD After RIC MRD HCT for AML with Post-Transplant Cyclophosphamide GvHD Prophylaxis

Yi-Bin Chen, MD, presents a patient case, detailing the symptomology and pathology of graft versus host disease, such as dry eyes, dry mouth, and difficulty swallowing, while also addressing steroid dependence as an indication for initiating second-line therapy.

A medical professional outlines the goals and challenges of communicating with his patient, emphasizing the importance of setting realistic expectations for halting disease progression and potentially achieving some degree of disease reversibility, while also exploring the roles of first-line and second-line therapies in the management of chronic graft versus host disease.

Yi-Bin Chen, MD, presents the results of the phase-3 randomized REACH-3 Trial, highlighting the superior best overall response rate of 75% in the experimental arm compared to 60% in the best-available therapy arm.

Yi-Bin Chen, MD, provides an overview of the iNTEGRATE and ROCKstar trials, underscoring their significance in the current treatment paradigm for graft versus host disease, particularly highlighting their ability to inhibit the fibrosis cascade, which offers substantial benefits for patient healing and recovery.

A medical expert delves into various aspects of second-line therapies, including dose reductions, potential adverse reactions, and the possibility of transfusions, all of which are important considerations when managing patients on second-line treatments.

Yi-Bin Chen, MD, proposes a strategy to enhance patients' quality of life by utilizing virtual monitoring as an alternative to requiring patients to travel to a transplant center, which includes regular remote assessments of blood work, such as liver function tests, lipid panels, and immunoglobulin levels.

In this expert analysis of the AGAVE-201 trial data, the efficacy of a monoclonal antibody in treating graft versus host disease is discussed, with the lowest dose of 0.3 mg/kg administered every 2 weeks demonstrating the highest response rates, exceeding 75%.

In his closing remarks, Yi-Bin Chen, MD, shares his aspirations for the future of graft versus host disease management, emphasizing the need for further clinical trials aimed at replacing steroids as the first-line treatment approach.