China News Service, Shanghai, February 19 (Reporter Chen Jing) The incidence of chronic graft-versus-host disease (cGVHD) after bone marrow transplantation is as high as 30% to 70%. Professor You Jianhua, Executive Director of the Hematology Department of Hainan Hospital, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, emphasized in an interview with reporters on the 19th: "It is very important to detect chronic graft-versus-host disease as early as possible, especially in the early stages of the disease, and to pay attention to 'preemptive intervention' of tissue fibrosis." The essential."
Professor You Jianhua introduced that chronic graft-versus-host disease is caused by the transplanted immune cells (graft) attacking the cells of the patient (host), destroying the original immune system of the autologous body, leading to inflammation and fibrosis in multiple tissues. (cGVHD) often goes through three stages, and more than half of patients are already at moderate to severe levels when they arrive at the hospital for diagnosis. He explained that this is because the three stages are usually continuous and occur simultaneously, that is, patients in the first stage may enter the second and third stages at the same time.
As the Executive Director of the Hematology Department of Hainan Hospital, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Professor You Jianhua shared clinical cases. In 2019, 7-year-old Shuoshuo (pseudonym) received a bone marrow transplant. Originally, the family thought that after the bone marrow transplant, Shuoshuo would completely say goodbye to the recurring pain. However, in 2020, Shuoshuo developed severe chronic graft-versus-host disease with fibrosis. Rejection and fibrosis once extended to his skin, joints, mouth and eyes. He was even admitted to the children's ICU due to severe pneumonia and respiratory failure. Guo Yu (pseudonym), 38 years old this year, also developed symptoms of chronic graft-versus-host disease with fibrosis such as cystitis, lung rejection, oral rejection, and eye rejection after bone marrow transplantation.
Professor You Jianhua said: "The current treatment of chronic graft-versus-host disease is mainly immunosuppressive therapy. Long-term use will suppress the body's own immunity and increase the risk of recurrence of the primary disease. It is especially difficult to solve the problem of fibrosis, which makes the problem of fibrosis It keeps getting worse. Traditional anti-rejection drugs mainly target the skin, but for fibrosis, especially pulmonary fibrosis, the clinical effectiveness is even less than 10%. Patients are in urgent need of innovative treatment options." Shuoshuo's mother told reporters : "In the past few years, we have been to several hospitals, across several provinces and cities, and have used four or five types of anti-rejection drugs, but we still cannot control the severe rejection reaction."
It is understood that at present, innovative drug treatment options are targeted at ROCK2, a new target in the treatment of chronic graft-versus-host disease. Professor You Jianhua told reporters that in August 2023, immunomodulators that can target ROCK2 were approved in China for the treatment of cGVHD patients 12 years old and above who have insufficient response to glucocorticoids or other systemic treatments: On the one hand, it can It can restore the patient's autoimmune homeostasis. On the other hand, it can effectively achieve anti-fibrotic effects, prevent the formation of fibrosis from the source, and directly act on fibrotic components to reduce fibrosis, allowing patients to regain their confidence in life.
You Jianhua said that Shuoshuo has received treatment for more than five months. At present, except for the partial relief of fibrosis in the skin, eyes, and joints, the child's mouth, esophagus, and gastrointestinal tract have achieved complete relief. Guo Yu said that after 5 weeks of treatment, his asthma was relieved a lot. It takes about ten minutes to walk back and forth from his home to the nearest subway station. He can not rest in the middle. "Although I am a little out of breath, it does not affect the continued walking. Comparing before and after, I feel much better."
Professor You Jianhua said that in addition to Shuoshuo and Guo Yu, 18 patients have benefited from the innovative treatment plan. When a patient first came to see a doctor, his skin rejection was so severe that he could not bend several fingers. The rejection of his feet was even more severe, and he completely lost his ability to take care of himself. After three months of treatment, he can now cook for himself. Recently, he has been able to fully close his hands and plays games on his mobile phone in his spare time. There is another patient who could not live without an oxygen machine before, but now he can walk and drive on his own, basically returning to normal. (over)