GVHD in Pediatrics: Acute and Chronic Risk

In this episode of ASTCT Talks, host Dr. Corey Cutler, MD, from Dana-Farber Cancer Institute, is joined by Dr. Pooja Khandelwal, MD (Cincinnati Children’s Hospital), Dr. Ben Watkins, MD (Tulane University), and Dr. Kenneth Cooke, MD (Johns Hopkins University) for an in-depth discussion on evolving strategies to prevent graft-versus-host disease (GVHD) in pediatric transplant.The conversation explores how leading centers are approaching GVHD prophylaxis across a range of clinical scenarios, with a focus on improving both acute and chronic GVHD outcomes. Experts compare platform-based approaches — including post-transplant cyclophosphamide, calcineurin inhibitor–based regimens, abatacept, and graft manipulation — and discuss how these strategies influence long-term transplant success.Key topics include:Current approaches to reducing acute and chronic GVHD in pediatric patients.Tradeoffs between prevention platforms, including immune reconstitution and infection risk.Emerging data on novel strategies, such as vitamin A and extended co-stimulation blockade.The role of GVHD-free survival as a key endpoint in transplant outcomes.Ongoing challenges and unmet needs in preventing chronic GVHD.While advances in prophylaxis are helping to reduce GVHD incidence, chronic GVHD remains a significant clinical challenge, underscoring the importance of continued innovation across the prevention-treatment continuum.This episode was supported by an educational grant fromIncyte.