AUTHOR=Wölfl Matthias , Qayed Muna , Benitez Carabante Maria Isabel , Sykora Tomas , Bonig Halvard , Lawitschka Anita , Diaz-de-Heredia Cristina 

TITLE=Current Prophylaxis and Treatment Approaches for Acute Graft-Versus-Host Disease in Haematopoietic Stem Cell Transplantation for Children With Acute Lymphoblastic Leukaemia

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 9 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.784377

DOI=10.3389/fped.2021.784377

ISSN=2296-2360

ABSTRACT=Acute graft-versus-host disease (aGvHD) continues to be a leading cause of morbidity and mortality following allogeneic haematopoietic stem cell transplantation. However, higher event-free survival (EFS) was observed in patients with acute lymphoblastic leukaemia (ALL) and grade II aGvHD versus patients with no or grade I GvHD in the randomized, controlled, open-label, international, multicentre Phase III For Omitting Radiation Under Majority age (FORUM) trial. This finding suggests that moderate-severity aGvHD is associated with a graft-versus-leukaemia effect which protects against leukaemia recurrence. In order to optimize the benefits of HSCT for leukaemia patients, reduction of non-relapse mortality – which is predominantly caused by severe GvHD – is of utmost importance. Herein, we review contemporary prophylaxis and treatment options for aGvHD in children with ALL and the key challenges of aGvHD management, focusing on maintaining the graft-versus-leukaemia effect without increasing the severity of GvHD