Novel approaches to the therapy of steroid-resistant acute graft-versus-host disease

Acute graft-versus-host disease (GVHD) is a principal impediment to the cure of patients with blood disorders after allogeneic stem cell transplantation. Thus, much attention has been paid to understanding the pathophysiology of GVHD with the hope that elucidation of the mechanisms of GVHD will improve our ability to both prevent and treat this complex problem. The working framework for allogeneic GVHD is derived from Billingham and Brent’s initial postulate that the development of GVHD requires that the graft contain immunologically competent cells and that the host contain membrane antigens lacking in the graft, which can be recognized as foreign [1].