ERS/EBMT clinical practice guideline on treatment of pulmonary chronic graft-versus-host disease in adults.

DOI
Publisher DOI
PubMed ID
38485149
Abstract
Chronic graft-versus-host disease (cGvHD) is a common complication after allogeneic haematopoietic stem cell transplantation, characterised by a broad disease spectrum that can affect virtually any organ. Although pulmonary cGvHD is a less common manifestation, it is of great concern due to its severity and poor prognosis. Optimal management of patients with pulmonary cGvHD is complicated and no standardised approach is available.The purpose of this joint European Respiratory Society and European Society for Blood and Marrow Transplantation Task Force was to develop evidence-based recommendations regarding the treatment of pulmonary cGvHD phenotype bronchiolitis obliterans syndrome in adults. A multidisciplinary group representing specialists in haematology, respiratory medicine, methodology as well as patient advocates formulated eight PICO (Patient, Intervention, Comparison, Outcome) and two narrative questions. Following the ERS standardised methodology, we conducted systematic reviews to address these questions and used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to develop recommendations.The resulting guideline addresses common therapeutic options (inhalation therapy, fluticasone-azithromycin-montelukast, imatinib, ibrutinib, ruxolitinib, belumosudil, extracorporeal photopheresis and lung transplantation), as well as other aspects of general management, such as lung functional and radiological follow-up and pulmonary rehabilitation, for adults with pulmonary cGvHD phenotype bronchiolitis obliterans syndrome. These recommendations include important advancements that could be incorporated in the management of adults with pulmonary cGvHD, primarily aimed at improving and standardising treatment and improving outcomes.
Date Issued
2024-03
Publication Type
Article
Subject(s)
Language(s)
en
Author(s)
Bos, Saskia
Murray, John
Marchetti, Monia
Cheng, Guang-Shing
Bergeron, Anne
Wolff, Daniel
Sander, Clare
Sharma, Akshay
Badawy, Sherif M
Peric, Zinaida
Piekarska, Agnieszka
Pidala, Joseph
Raj, Kavita
Penack, Olaf
Kulkarni, Samar
Beestrum, Molly
Linke, Andrea
Rutter, Matthew
Coleman, Courtney
Schoemans, Hélène
Stolz, Daiana
Vos, Robin
Additional Credits
Journal
European respiratory journal
Publisher
European Respiratory Society
ISSN
0903-1936
Access(Rights)
open.access
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