Treatment options in steroid-refractory acute graft-versus-host disease following hematopoietic stem cell transplantation

Graft-versus-host disease (GVHD) isan exaggerated immune response of the donor’s cells against the recipient’s tissue and is a major barrier to successful allogeneic hematopoietic stem cell trans-plantation (HSCT).1 Despite routine pro-phylaxis with immunosuppressants such as cyclosporine, tacrolimus, steroids, methotrexate, and antithymocyte globulin (ATG), GVHD remains a major compli-cation of allogeneic HSCT. GVHD is classified as either the acute or chronic form, primarily by the onset of its clinical manifestations (within or beyond 100 days of the transplantation)2; however, it can also be defined by the clinical mani