[基础医学]2012第54届美国血液年会ASH进展.ppt

* p1924 * * 1926 * * * Best standard therapy for cGVHD:Clinical trial Agent Nilotinib MSC Alefacept IL-2 Bortezomib Pomalidomide Imatinib vs ritux Montelukast（白三） Rituximab ECP Ofatumumab SIRO vs SIRO/CSA Setting 2nd line 2nd line 2nd line 2nd line 2nd line 2nd line Skin sclerosis BOS 1st line 1st line 1st line 1st line Design Phase 1 Phase 1 Phase 1/2 Phase 2 Phase 2 Phase 2 Phase 2 Phase 2 Phase 2 Phase 2 Phase 1/2 Phase 2/3 Institution Stanford.CA Karolinska.Sweden Jerusalem.Israel DFCI.Massachusetts Baylor.Texas NCI.Maryland US cGVHDConsortium NCI.Maryland Nantes.France Therakos,multicenter Moffitt,Florida BMT CTN.USA ClnicalTrials .gov.accessed Nov.30.2012 * Are we making progress in GVHD prophylaxis and treatment？ Clear progress is made in clinical characterization，standardization and multicenter collaboration Acute GVHD -Calcineurin-inhibitor prophylaxis a gold standard，new strategies - Steroids standard front-line therapy，no second-line standard Chronic GVHD - No standard prophylaxis，ATG, TCD, High-Cy show promise - Steroids standard front-line therapy，no second-line standard Emerging biology-based agents Advances in biomarkers and biology will likely lead to individualized and better treatments in the near future An Algorithm Combining Clinical Characteristics and Day 7 Biomarker Concentrations Predicts Future GVHD Following Related Donor HSCT Abstract 463: Andrew C. Harris, University of Michigan, Ann Arbor, MIBlood and Marrow Transplant Program, University of Michigan, Ann Arbor, MIPediatric Blood and Marrow Transplant Program, University of Michigan, Ann Arbor, MI Objective: We have now evaluated whether a combination of pre-HCT clinical characteristics and GVHD biomarkers measured early post-HCT can predict the future occurrence of GVHD with sufficient accuracy and lead time to facilitate the preemptive treatment of a large majority of patients at high risk prior to the onset of GVHD symptoms. Methods: 393 pat