Graft vs Host Disease Highlights From EBMT 2023

Mohamad Mohty, MD; Robert Zeiser, MD


June 28, 2023

Graft vs host disease (GVHD) is a serious complication experienced by allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. New studies offering insight into prophylaxis, novel therapies, and the pathophysiology of this complication top the GVHD highlights from the 2023 European Society for Blood and Marrow Transplantation (EBMT) Annual Meeting, as reported by Drs Mohamad Mohty of Sorbonne University and Robert Zeiser of Freiburg University Medical School.

The panelists begin by discussing the first positive phase 3 study for prevention of lower gastrointestinal (GI) GVHD in patients who had received allo-HSCT. In the study, vedolizumab, an integrin inhibitor, was given prophylactically, resulting in a 7.1% incidence of GI GVHD compared with 18.8% with placebo.

Turning to management of acute GVHD, Drs Mohty and Zeiser report on a study of fecal microbiota transplantation (FMT) for treatment of high-risk GVHD that showed promising responses. They describe FMT as an innovative approach for patients with GVHD.

Next, they discuss two studies involving ruxolitinib. The first, a phase 3 study, examined the benefit of ruxolitinib after patients had nonresponse to best available therapy. This study showed that patients who "crossed over" to ruxolitinib achieved comparable responses to those treated initially with ruxolitinib. The second study examined ruxolitinib's prophylactic benefits, reinforcing the idea that GVHD prevention is preferable to treating the disease.


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