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Prophylaxis and treatment of acute graft-versus-host disease: current state, implications of new immunopharmacologic compounds and future strategies to prevent and treat acute GVHD in high-risk patients.

Acute GVHD continues to be a clinical problem, particularly after transplants from HLA-non-identical donors. Standard prophylaxis at the present time involves the use of MTX and CYA with or without the addition of glucocorticoids. The use of moAbs, in particular humanized forms such as HAT, may improve these results. A selective manipulation of cytokines (IL-1, tumor necrosis factor and others) or their receptors or both may be clinically useful. The current use of a broad variety of approaches is a clear indication that the optimum treatment has been elusive.