Alemtuzumab treatment for steroid-refractory acute graft-versus-host disease leads to severe immunosuppression but not to relapse of malignant disease

The fundamental therapeutic mechanism of allogeneic hematopoietic stem cell transplantation (HCT) in hematologic malignancies is the graft-versus-tumor reactivity mediated by donor T cells. While severe acute graft-versus-host disease (aGVHD) is a clinical situation to be avoided, patients affected tend to show fewer
relapses [3]. Even so, aGVHD is the most relevant complication of allogeneic HCT and the mortality of steroid-refractory grade III and IV aGVHD is unacceptably high. The response to therapy after fi rstline treatment with glucocorticoids is still limited despite the advantage of recently introduced ruxolitinib.

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