Pharmacologic Prevention of Acute Graft-versus-Host Disease


Book Section

© 2016 John Wiley & Sons, Ltd. All rights reserved. Early human transplants of allogeneic marrow were often complicated by graft-versus-host disease (GVHD). This chapter focuses primarily on the most frequently used drugs for immunosuppression or immunomodulation for GVHD. It discusses the pathogenesis, alloreactivity, and the predictive factors utilized as targets for agents in the prevention of GVHD. Non-specific immunosuppressive drugs Corticosteroids have been combined with other immunosuppressants in prophylaxis against GVHD, but is most frequently used as front-line therapy in the treatment of established GVHD. At the cellular level, MTX exerts its cytotoxic effect by inhibiting dihydrofolate reductase (DHFR). Methotrexate (MTX) is an analog of aminopterin, the folic acid antagonist introduced in 1948 for the treatment of acute leukemia. Specific T-cell immunosuppressive drugs Cyclosporine (CSP) is a neutral hydrophobic cyclic peptide composed of 11 amino acids. Tacrolimus is a macrolide antibiotic extracted from the soil fungus Streptomyces tsukubaensis and exhibit a similar selective immunosuppressive activity.

Full Text

Duke Authors

Cited Authors

  • Chao, NJ

Published Date

  • January 1, 2016

Volume / Issue

  • 2-2 /

Book Title

  • Thomas' Hematopoietic Cell Transplantation: Fifth Edition

Start / End Page

  • 990 - 1006

International Standard Book Number 13 (ISBN-13)

  • 9781118416006

Digital Object Identifier (DOI)

  • 10.1002/9781118416426.ch81

Citation Source

  • Scopus