Understanding the mechanism of cGvHD: Inflammation and Fibrosis

Author: Sanofi

Editorial Team

Prescribing Information Rezurock belumosudil (tablets)

Insulin Trurapi (Insulin aspart 100 units/mL)

Early onset and complexity of fibrosis in cGvHD

Fibrosis in cGvHD may happen earlier than expected.

Inflammation and fibrosis can both occur within the first year post allogenic hematopoietic stem cell transplantation (alloHSCT), but sometimes develop many years after.^1-2
The exact relationship between inflammation and fibrosis is complex and not yet fully understood.³
Fibrosis may be viewed as a natural consequence of inflammation, but in fact, research suggests it may begin developing prior to any symptoms of cGvHD.^4-6

The need for early intervention

Despite the heterogeneity of cGvHD presentation, the defining features are inflammation and fibrosis^1,3 which can affect multiple organs.

The condition can affect the skin, liver, lungs, eyes and gastrointestinal system, among others.

Acting as early as possible to target both the fibrotic and inflammatory components of cGvHD could be crucial in appropriate patients.^7,9

Gain a deeper understanding of the mechanisms behind cGvHD, including its key drivers - inflammation and fibrosis. (For full interactivity, download and view in Adobe Acrobat).

Abbreviations

References

1. Jagasia MH, Greinix HT, Arora M, et al. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: |. The 2014 Diagnosis and Staging Working Group report. Biol Blood Marrow Transplant. 2015;21(3):389-401. e1. doi:10.1016/j.bbmt.2014.12.001

2. Arora M, Cutler CS, Jagasia MH, et al. Late acute and chronic graft-versus-host disease after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2016;22(3):449- 455. doi:10.1016/j.bbmt.2015.10.018

3. Cooke KR, Luznik L, Sarantopoulos S, et al. The biology of chronic graft-versus-host disease: a task force report from the National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease. Biol Blood Marrow Transplant.
2017:23(2):211-234. doi: 10.1016/j.bbmt.2016.09.023

4. Hamilton BK. Updates in chronic graft-versus-host disease. Hematology Am Soc Hematol Educ Program. 2021;2021(1):648-654. doi:10.1182/hematology.2021000301

5. Logan BR, Gafken PR, Paczesny S. Validated graft-specific biomarkers identify patients at risk for chronic graft-versus-host disease and death. J Clin Invest. 2023;133(15):e168575.
doi:10.1172/JCI168575

6. Yu J, Storer BE, Kushekhar K, et al. Biomarker panel for chronic graft-versus-host disease. J Clin Oncol. 2016;34(22):2583-2590. doi: 10.1200/JCO .2015.65.9615

7. Kitko CL,White ES, Baird K. Fibrotic and sclerotic manifestations of chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2012;18(1 suppl):S46-S52. doi:10.1016/j. bbmt.2011.10.021

8. Bachier CR, Aggarwal SK, Hennegan K. et al. Epidemiology and treatment of chronic graft-versus-host disease post-allogeneic hematopoietic cell transplantation: a US claims analysis. Transplant Cell Ther. 2021;27(6):504.e1-504.e6, doi: 10.1016/j.jtot.2020.12.027.

9. Jagasia M, Lazaryan A, Bachier CR, et al. ROCK2 inhibition with belumosudil (KD025) for the treatment of chronic graft versus- host disease. J Clin Oncol. 2021;39(17):1888-1898. doi:10.1200/ JCO.20.02754

MAT-XU-2403539 (v1.0) Date of Preparation: September 2024