Chronic graft-versus-host disease presenting as acute polymyositis: A case series and systematic review

Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with an increased risk of graft- versus-host disease (GvHD), a strong prognostic predictor of early mortality within the first 2 years following allo-HSCT. The objective of this study was to describe the harm outcomes reported among patients receiving second- and third-line treatment as part of the management for GvHD via a systematic literature review. Methods: A total of 34 studies met the systematic review inclusion criteria, reporting adverse events (AEs) across 12 different second- and third-line therapies. Results: A total of 14 studies reported AEs across nine different therapies used in the treatment of acute GvHD (aGvHD), 17 studies reported AEs of eight different treatments for chronic GvHD (cGvHD) and 3 reported a mixed population. Infections were the AE reported most widely, followed by haematologic events and laboratory abnormalities. Reported infections per patient were lower under extracorporeal photopheresis (ECP) for aGvHD (0.267 infections per patient over 6 months) relative to any of the therapies studied (ranging from 0.853 infections per patient per 6 months under etanercept up to 1.998 infections per patient on inolimomab). Conclusion: The reported incidence of infectious AEs in aGvHD and grade 3–5 AEs in cGvHD was lower on ECP compared with pharmaceutical management.

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Preclinical Studies of MSC-Derived Extracellular Vesicles to Treat or Prevent Graft Versus Host Disease: a Systematic Review of the Literature

Stem Cell Reviews and Reports ◽

10.1007/s12015-020-10058-x ◽

2020 ◽

Author(s):

Manika Gupta ◽

Alvin Tieu ◽

Mitchell Slobodian ◽

Risa Shorr ◽

Dylan Burger ◽

...

Keyword(s):

Systematic Review ◽

Extracellular Vesicles ◽

Graft Versus Host Disease ◽

Preclinical Studies ◽

Review Of The Literature ◽

Host Disease ◽

Graft Versus Host

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Management of oral Graft versus Host Disease with topical agents: A systematic review

Medicina Oral Patología Oral y Cirugia Bucal ◽

10.4317/medoral.20968 ◽

2016 ◽

pp. e72-e81 ◽

Cited By ~ 6

Author(s):

R Albuquerque ◽

Z Khan ◽

A Poveda ◽

J Higham ◽

A Richards ◽

...

Keyword(s):

Systematic Review ◽

Graft Versus Host Disease ◽

Host Disease ◽

Graft Versus Host

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Effectiveness of immunosuppression minimisation, conversion or withdrawal strategies in paediatric solid organ and haematopoietic stem cell transplantation: a protocol of a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-037721 ◽

2020 ◽

Vol 10 (12) ◽

pp. e037721

Author(s):

Carlos Martin Saborido ◽

Alberto M Borobia ◽

Javier Cobas ◽

Lorenzo D'Antiga ◽

Esteban Frauca ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Blood Pressure ◽

Clinical Trials ◽

Graft Versus Host Disease ◽

Graft Rejection ◽

Host Disease ◽

Graft Versus Host ◽

Acute Graft

IntroductionPaediatric transplantation is the only curative therapeutic procedure for several end-stage rare diseases affecting different organs and body systems, causing altogether great impact in European children’s health and quality of life. Transplanted children shift their primary disease to a chronic condition of immunosuppression to avoid rejection. Longer life expectancy in children poses a greater risk of prolonged and severe side effects related to long-term immunosuppressive (IS) disabilities and secondary cancer susceptibility. The goal remains to find the best combination of IS agents that optimises allograft survival by preventing acute rejection while limiting drug toxicities. This systematic review will aim to determine the optimal IS strategy within the so-called minimisation, conversion or withdrawal strategies.Methods and analysisWe will search the following databases with no language restrictions: Cochrane Central Register of Controlled Trials in the Cochrane Library, OvidSP Medline and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily; OvidSP Embase Classic+Embase; Ebsco CINAHL Plus, complete database; WHO International Clinical Trials Registry Platform search portal. We will include controlled and uncontrolled clinical trials along with any prospective or retrospective study that includes a universal cohort (all participants from a centre/region/city over a certain period). Cases series and cross-sectional studies are excluded. Two review authors will independently assess the trial eligibility, risk of bias and extract appropriate data points. The outcomes included in this review are: patient survival, acute graft rejection, chronic graft rejection, diabetes, graft function, graft loss, chronic graft versus host disease, acute graft versus host disease, surgical complications, infusion complications, post-transplant lymphoproliferative disease, liver function, renal function, cognition, depression, health-related quality of life, hospitalisation, high blood pressure, low blood pressure, cancer—other, cancer—skin, cardiovascular disease, bacterial infection, Epstein-Barr infection, cytomegalovirus infection, other viral infections and growth.

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