Despite improvements in prevention and treatment of acute graft‐versus‐host disease (GVHD), chronic GVHD (cGVHD) remains a significant contributor to morbidity and mortality of allogeneic transplant patients. Chronic GVHD remains a leading cause of late complications posttransplant and is impacted by donor‐, patient‐, and transplant‐related (hematopoietic cell transplant [HCT]) factors. Advances in the biological understanding of cGVHD have provided opportunities to improve clinical interventions for prevention and treatment. Expansion of posttransplantation cyclophosphamide beyond haploidentical HCTs has transformed alternative donor, matched, and mismatch GVHD outcomes and is currently being investigated in two upcoming clinical trials network prophylaxis studies. Although corticosteroids remain the cornerstone therapy, several clinical trials are prospectively investigating the utility of using novel agents in combination with corticosteroids as upfront therapy to mitigate prolonged steroid exposure. Several treatment options for patients with steroid‐refractory cGVHD are currently being investigated, and advances have resulted in ibrutinib becoming the first cGVHD agent approved by the U.S. Food and Drug Administration. We review recent advances in understanding of cGVHD pathophysiology and new approaches for the prevention and treatment of cGVHD.

中文翻译：

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慢性移植物抗宿主病的不断发展的治疗选择。

尽管在急性移植物抗宿主病（GVHD）的预防和治疗方面有所改进，但慢性GVHD（cGVHD）仍然是同种异体移植患者发病率和死亡率的重要因素。慢性GVHD仍然是移植后晚期并发症的主要原因，并受到供体，患者和移植相关（造血细胞移植[HCT]）因素的影响。对cGVHD的生物学理解的进步为改善预防和治疗的临床干预提供了机会。移植后环磷酰胺的扩展已超出单倍性HCT，已改变了供体，匹配和不匹配的GVHD结果，目前正在两项即将开展的临床网络预防研究中进行研究。尽管皮质类固醇仍然是基础疗法，数项临床试验正在前瞻性地研究将新型药物与皮质类固醇结合使用作为缓解长期类固醇暴露的前期治疗方法的实用性。目前正在研究针对类固醇难治性cGVHD患者的几种治疗选择，并且取得的进展使依鲁替尼成为美国食品和药物管理局批准的第一种cGVHD药物。我们回顾了解cGVHD病理生理学的最新进展以及预防和治疗cGVHD的新方法。并取得了进展，使依鲁替尼成为美国食品和药物管理局批准的第一种cGVHD药物。我们回顾了解cGVHD病理生理学的最新进展以及预防和治疗cGVHD的新方法。并取得了进展，导致依鲁替尼成为美国食品和药物管理局批准的第一种cGVHD药物。我们回顾了解cGVHD病理生理学的最新进展以及预防和治疗cGVHD的新方法。