Quelling an Internal Civil War: New and Emerging Treatments for Graft-vs-Host Disease




The leading cause of non-relapse post- allogeneic hematopoietic stem cell transplant mortality is GvHD manifesting as immunobiological warfare waged by the donor cells against multiple organ systems in the recipient. Approximately 50% of transplant patients die not from their hematologic disease, but from GvHD. Theories on the pathogenesis of GvHD are fraught with controversy. The complex pathobiological underpinnings of GvHD have not been thoroughly elucidated and more effective resolution of the disease has been impeded by lack of consensus on diagnostic biomarkers and staging system for determining response and prognosis. Treatment of GvHD after allo-HSCT now depends on achieving a therapeutic symmetry between steroids vs new and emerging agents with a variety of differing mechanisms of action. This educational activity will review and assess these treatment options and will raise clinicians’ level of awareness about the immunobiological signaling pathways involved in the pathophysiology of this disease as well as diagnostic and grading strategies.



Nelson Chao, MD, MBA
Professor of Medicine
Division of Hematology Malignancies and
Cellular Therapy/BMT Director
Duke University
Durham, NC

Release date: April 13, 2021
Expiration date: May 31, 2021
Estimated time to complete activity: 60 minutes



This educational activity has been designed for hematologists/oncologists, oncology and hematology fellows, and other members of the oncology care team who need to be aware of recent and emerging advances the prevention and treatment of GvHD.


Upon completion of this educational activity, participants will be able to:

  • Characterize current knowledge about the biology and pathophysiology of GvHD
  • Employ effective diagnostic and grading strategies for acute and chronic GvHD
  • Elucidate still-evolving insights into the role of T- and B-cell signaling pathways in the development of GvL and GvHD
  • Analyze currently approved and emerging agents to treat GvHD

There are no fees for participating and receiving CME credit for this activity. During the period of April 13, 2021 through May 31, 2021, participants must:

  • Read the learning objectives and faculty disclosures
  • Complete the pretest
  • This activity is available in two formats – either as a downloadable slide set or as a downloadable audio/slide resource. Download the slide deck or audio/slide resource and study the activity.
  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.




The University of Nebraska Medical Center, Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


The University of Nebraska Medical Center, Center for Continuing Education designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For information about accreditation of this activity, please contact Continuing Education at (402) 559-4152 or conted@unmc.edu


The University of Nebraska Medical Center, Center for Continuing Education and Integrity Continuing Education requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The following faculty/planners reported the financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of these CME activities:

Nelson Chao, MD, MBA has nothing to disclose.

Michelle R. Rizzo, ELS, hereby states that she or her spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.


This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Integrity Continuing Education and the University of Nebraska Medical Center, Center for Continuing Education, do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Integrity Continuing Education or the University of Nebraska Medical Center, Center for Continuing Education. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


When you participate in an online educational activity sponsored by Integrity Continuing Education, Inc., you will be asked for your name, degree(s), affiliation(s), street address, telephone number, fax number, and…(continued)


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The information provided in this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.



Co-Provided by The University of Nebraska Medical Center, Center for Continuing Education and Integrity Continuing Education, Inc.


Supported by educational grants from Incyte, Jazz Pharmaceuticals, Pharmacyclics LLC, an AbbVie Company, and Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC.

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