Statistics on the Incidence of Chronic GVHD

EP: 1.Graft versus Host Disease Background

EP: 2.Overview of GVHD Risk Factors

EP: 3.Current GVHD Prophylaxis Strategies

EP: 4.Signs and Symptoms of Acute and Chronic GVHD

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EP: 5.Statistics on the Incidence of Chronic GVHD

EP: 6.Identification of Patients at High Risk for GVHD

EP: 7.Assessment of Chronic GVHD Symptoms

EP: 8.The NIH Clinical Scoring of Organ Systems

EP: 9.The Chronic GVHD Treatment Paradigm

EP: 10.Patient Case: A 48-Year-Old Man with Chronic GVHD

EP: 11.Treatment Goals for a Patient With Chronic GVHD

EP: 12.Steroid-Refractory Chronic GVHD Background

EP: 13.Therapy Options for Steroid-Refractory Chronic GVHD

EP: 14.Ibrutinib as Second-Line Therapy for Steroid-Refractory Chronic GVHD

EP: 15.The iNTEGRATE Trial: Ibrutinib With Prednisone as First-Line Therapy for cGVHD

EP: 16.The REACH3 Clinical Trial of Ruxolitinib in Chronic GVHD

EP: 17.Clinical Experience with Ruxolitinib for cGVHD

EP: 18.The ROCKstar Study of Belumosudil in cGVHD

EP: 19.Real-World Experience with Belumosudil

EP: 20.Summary of Axatilimab for cGVHD

EP: 21.Therapy Selection for Patients with Chronic GVHD

EP: 22.Discussion of Long-Term Effects of GVHD Therapy

EP: 23.Future Directions in Graft Versus Host Disease

Transcript:

Yi-Bin Chen, MD: If there’s one thing we’ve done over the last few decades of transplant, we’ve improved the treatment and the prevention of acute complications. If you look at outcomes, our early nonrelapse mortality has significantly decreased. If you look at large series of patients with either severe or even steroid refractory graft versus host disease [GVHD] through the decades, their outcomes have improved. Some of that is from newer treatments, but some of that is from advances in medicine, better treatment of infections, and supportive care, and understanding how to take care of our patients, or even patient selection. And so, with more patients surviving, I think the burden of chronic graft versus host disease, at least in the last 10 years, has increased.

You can see from this slide that if you look at large registry data, 40% to 50% of patients who undergo modern transplant will develop some sort of chronic graft versus host disease that requires treatment. And getting back to what Catherine said, over two-thirds of these patients had a prior diagnosis of acute [GVHD]. That remains the biggest risk factor one can identify, early reactivity breeds alloreactivity. All these patients with chronic graft versus host diseasewho are treated, as you’ll see from the trial data that we discuss, it’s fairly common, especially now with newer options, for many of our patients to be given multiple therapies after steroids. The majority of our patients, once we treat them for chronic graft versus host disease, do not achieve a complete remission and will require more and more care as time goes on. But I think we’ve definitely made advances in the field, and we’re going to review many of those.

Transcript edited for clarity.