Clinical Perspectives for Systemic Therapy in Steroid-Refractory cGVHD
Panelists discuss how prophylaxis against opportunistic infections is essential for patients on immunosuppressive therapy for chronic graft-vs-host disease (cGVHD).
Steroid Management and Prophylaxis
This segment focuses on steroid management and prophylaxis in chronic GVHD patients. The panel discusses steroid tapering approaches (typically 10-mg reductions every 4 weeks, slowing at 20 mg daily) and addressing steroid complications. There's consensus on the importance of infection prophylaxis for chronic GVHD patients on immunosuppression, including:
- Prophylaxis against Pneumocystis jirovecii pneumonia with Bactrim (double-strength daily, if tolerated)
- Coverage for encapsulated organisms
- Antiviral prophylaxis, particularly for varicella zoster virus
- Antifungal/mold coverage for patients on high-dose steroids
The panel notes differences in vaccination approaches between centers, with most agreeing on providing flu and COVID-19 vaccinations regardless of immunosuppression status, while delaying Shingrix until patients are off immunosuppression for extended periods.
Ruxolitinib Effective as Second-Line Therapy for Chronic GvHD
July 15th 2021In an interview with Targeted Oncology, Stephanie Lee, MD, MPH, reviewed the updated data from the REACH3 trial along with the efficacy of ruxolitinib in the greater chronic graft versus host disease population.
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Clinical Treatment Act Aims to Improve Survival, Close Racial Health Care Gap
June 28th 2021Across the United States, the health insurance coverage gap continues to impact millions of patients who are largely low-income or are racial minorities. After years of lobbying, Congress has passed the Clinical Treatment Act, which is legislation designed to improve access to health coverage.
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