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REVIEW article

Front. Immunol.
Sec. Alloimmunity and Transplantation
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1304065
This article is part of the Research Topic

New Frontiers in Immune Tolerance in Hematopoietic Stem Cell Transplantation

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Janus Kinase Inhibition in the Treatment and Prevention of Graft-versus-host Disease

Elisa S. De Togni1* Oladipo Cole2 Ramzi Abboud2*
  • 1John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, United States
  • 2Divisions of Hematology & Oncology, John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, United States

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Graft-versus-host disease (GVHD) is a significant cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). For many years, corticosteroids have been the mainstay treatment for GVHD, but cases of steroid-refractory GVHD and the severe adverse effects of high-dose corticosteroids have increased the need for preventative and therapeutic strategies for GVHD. Due to the nature of alloreactive T cells, GVHD is inherently linked to the graft-versus-leukemia (GVL) effect, the therapeutic driving force behind stem cell transplantation. A considerable clinical challenge is to preserve GVL while suppressing GVHD. The field of GVHD research has greatly expanded over the past decades, including advancements in T cell modulation and depletion, antibody therapies, chemotherapeutics, cellular therapies, and Janus kinase inhibition. In this review, we discuss current approaches and advances in the prophylaxis and treatment of GVHD with a focus on new emerging advancements in Janus kinase inhibitor therapy.

Keywords: GvHD (graft-versus-host disease), JAK, Janus kinase (JAK), Hematopoeietic stem cell transplantation, acute GVHD, chronic GVHD, JAK inhibitor, Ruxolitinb

Received: 28 Sep 2023; Accepted: 18 Jan 2024.

Copyright: © 2024 De Togni, Cole and Abboud. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dr. Elisa S. De Togni, John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, 63110, Missouri, United States
Dr. Ramzi Abboud, Divisions of Hematology & Oncology, John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, Saint Louis, 63110, Missouri, United States