Opinion
Video
Early Challenges in the cGVHD Journey
Panelists discuss how early diagnosis, evolving treatment strategies, and pharmacist-led interventions are advancing chronic graft-vs-host disease (cGVHD) management by addressing unmet needs, improving care coordination, and enhancing patient access to emerging therapies.
Advancing Chronic Graft-Vs-Host Disease Management: Early Diagnosis, Treatment Strategies, and Pharmacist-Led Interventions
This Pharmacy Times peer exchange focuses on the evolving landscape of chronic graft-vs-host disease (cGVHD) management, exploring unmet needs, emerging therapies, and the crucial role of pharmacists in optimizing care. The discussion highlights strategies to improve early diagnosis, guide treatment selection based on updated clinical guidelines, and enhance patient access to advanced therapies. Emphasis is placed on improving care coordination and empowering patients through education and support.
A major barrier to effective cGVHD management is timely diagnosis. Clinicians often encounter vague or nonspecific symptoms, such as chronic nausea or dry eye, which can be misattributed to other causes. As patients move further from transplant, follow-up care becomes less frequent, increasing the risk of delayed diagnosis and progression to advanced, fibrotic stages. The absence of consistent screening protocols further complicates early identification, leading to reduced treatment effectiveness and more challenging disease presentations.
In terms of treatment, corticosteroids remain the standard first-line therapy, but nearly half of patients do not respond adequately. Treatment decisions are guided by a combination of consensus severity scoring, symptom burden, and patient-reported outcomes. The discussion emphasizes a patient-centric approach, balancing clinical data with quality-of-life considerations. Early initiation of second-line therapies is often necessary when symptoms persist or escalate despite steroid use. Pharmacists are instrumental in managing these complex regimens, educating patients, monitoring for adverse effects, and supporting adherence. By setting realistic expectations and tailoring care, pharmacists help drive improved outcomes in this long-term, multifaceted condition.
