Chronic Graft-Versus-Host Disease

Chronic GVHD (cGVHD) is the most relevant cause of late non-relapse morbidity and subsequent mortality (approximately 25%) following allo-HCT (Grube et al. 2016). Its incidence is approximately 50% among all patients following allo-HCT and has increased during the last two decades due to increasing patient age and increasing use of unrelated and/or mismatched donors, RIC regimens, PBSC with application of standard GVHD prophylaxis (calcineurin inhibitor [CNI] + MMF or MTX) only (Arai et al. 2015). While the incidence of cGVHD is lower (6–40%) in children, its incidence rises to 60% as age increases (Baird et al. 2010; Sobkowiak-Sobierajska et al. 2022).