NCCN releases guidelines for recognizing and managing GVHD after stem cell transplantation

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The National Comprehensive Cancer Network published NCCN Guidelines for Patients: Graft-Versus-Host Disease, weeks after Orencia became the first drug approved by FDA for the prevention of GVHD (The Cancer Letter, Dec. 17, 2021). 

“The symptoms [of GVHD] can be very tricky and manifest suddenly, in unusual ways, sometimes years after the transplant,” Ayman A. Saad, professor of internal medicine at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and chair of the NCCN Guidelines Panel for Hematopoietic Cell Transplantation, said in a statement. 

“The most important piece of advice is to take GVHD seriously, but not panic,” Alison W. Loren, director of the Blood & Marrow Transplant, Cell Therapy & Transplant Program at Abramson Cancer Center of the University of Pennsylvania and vice chair of the NCCN Guidelines Panel for Hematopoietic Cell Transplantation, said in a statement. “GVHD is very common yet poorly understood, even by physicians. Hopefully, this book brings some order to the chaos by sharing evidence and uniformity.”

Saad and Loren encouraged transplant recipients to talk to their doctor about anything that feels different after the procedure, even years later, especially issues including: rash, diarrhea, nausea, vomiting, poor appetite, fatigue, jaundice, joint stiffness, mouth sores, and dry eyes or mouth.

“NCCN believes that the best management of any patient with cancer is a clinical trial,” Loren said. “Some trials require that patients haven’t received any previous treatment, so it’s important to bring it up right away and not miss the opportunity for the best possible care while also adding to our knowledge about how the immune system works.”

NCCN Guidelines for Patients feature charts, images, and a glossary of medical terms—and include suggested questions to ask a doctor.

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Arjan Gower, a hematologist/oncologist at the UCLA Health Jonsson Comprehensive Cancer Center, received a $950,000 grant from the National Comprehensive Cancer Network and Taiho Oncology Inc. to help launch a multi-institutional clinical trial to test zipalertinib, an investigational drug that targets specific EGFR mutations, including Exon 20 insertions, which are known to drive cancer growth and resist standard treatments. 
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