Dr. Donato on Advances in the Prevention of GVHD

Michele L. Donato, MD, medical director, Blood and Marrow Collection Facility, John Theurer Cancer Center, discusses advances in the prevention of graft-versus-host disease (GVHD).

It is clear now that younger donors perform better: They experience less GVHD, better disease control, and fewer treatment-related complications. Donor selection is crucial in the prevention of GVHD, Donato says, and physicians now have the capacity to select donors where the indigence of GVHD will be less.

GVHD is of particular concern in haploidentical and half-match transplants, but the process of giving post-transplant, high-dose cyclophosphamide to kill activated T cells has been effective in this space. This process has made it possible to do haploidentical and half-match transplants with no more ​GVHD than in a fully-matched sibling and has also been looked at in unrelated donors.