Evolving Paradigms in Chronic Graft-Versus-Host Disease: From Global Immunosuppression to Precision Targeted and Cell-Based Therapies
摘要
Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a well-established treatment for a range of medical conditions. However, the procedure carries with it a significant risk of chronic graft-versus-host disease (cGVHD), which can have a considerable impact on patients’ quality of life and clinical outcomes. In recent years, there has been a marked shift in treatment strategies for this condition, with greater emphasis being placed on novel targeted therapies and cell therapies that target specific pathways. This shift in approach signifies a more profound comprehension of the pathogenesis of the condition, particularly with respect to abnormal T/B cell activation, tissue fibrosis progression, and immune tolerance imbalance. This article systematically reviews the current treatment framework and latest advances in cGVHD, covering the evolution from first-line immunosuppression to diverse precision targeted drugs and cellular therapy strategies. The study methodically analyses their positioning in clinical practice and the challenges encountered, with the objective of providing theoretical support and practical guidance for refined, individualised clinical management of cGVHD.