Summary
The video provides a comprehensive overview of graft-versus-host disease (GVHD) in the context of bone marrow transplants. It covers the pathophysiology, diagnosis, symptoms, staging criteria, treatment options including prophylactic regimens and novel therapies, as well as considerations for managing steroid-refractory GVHD. The discussion also touches on the importance of selecting appropriate GVH prophylaxis, minimizing T-cell infusion to reduce chronic GVHD risk, and utilizing mesenchymal stem cells in patient care.
Chapters
Introduction and Contact Hours
Definition of GVHD
Background on BMT
Purpose of Transplant
Types of GVHD
Pathophysiology of GVHD
Diagnosis and Symptoms of GVHD
Treatment of GVHD
GVHD Prophylaxis
Steroid Refractory GVHD
Discussion on GVH Prophylaxis
Risk Factors for Cells in the Actual Product
Patient's Case and Treatment
Closure and Appreciation
Introduction and Contact Hours
The video begins with introductions and information on how to earn contact hours. Attendees are reminded to fill out a post-evaluation survey to receive contact hours.
Definition of GVHD
The speaker defines graft-versus-host disease (GVHD) and discusses its pathophysiology and impact on patients.
Background on BMT
Brief background information on bone marrow transplants (BMT), including the different types of stem cells used and the sources of stem cells.
Purpose of Transplant
Exploration of the purpose of a transplant as a rescue from ablative therapy and to overcome drug resistance, with a focus on using donor cells for treatment.
Types of GVHD
Discussion on the types of GVHD, including acute, chronic, and overlap syndrome, along with their characteristics and timing of occurrence.
Pathophysiology of GVHD
Explanation of the pathophysiology of GVHD, detailing how transplanted tissue or stem cells attack the recipient's body and the immune responses involved in the process.
Diagnosis and Symptoms of GVHD
Description of the diagnosis and symptoms of GVHD, including skin, GI tract, liver, and respiratory manifestations, as well as staging criteria for GVHD.
Treatment of GVHD
Overview of GVHD treatment options, including immunosuppressive drugs like tacrolimus and methotrexate, and the use of systemic corticosteroids. Other treatments such as extracorporeal photopheresis (ECP) and novel therapies are also discussed.
GVHD Prophylaxis
Explanation of post-transplant cyclophosphamide as a common prophylactic regimen for GVHD prevention, with a focus on its mechanism of action and effectiveness.
Steroid Refractory GVHD
Information on the treatment of steroid-refractory GVHD, including different therapeutic options and considerations for managing patients with refractory disease.
Discussion on GVH Prophylaxis
The discussion revolves around the benefits and costs of using a specific type of GVH prophylaxis over the standard treatment. Mention of using it in a couple of patients and the risk of GVHD with deceased stem cells is highlighted.
Risk Factors for Cells in the Actual Product
The speaker addresses the topic of using marrow versus stem cells, emphasizing the reduced risk of chronic GVHD when infusing less T-cells into the patient. Factors like HLA mismatched donors are also discussed.
Patient's Case and Treatment
A specific patient's case is brought up, mentioning the use of Jack and the impact on the patient's condition. The discussion delves into gut rest, diarrhea improvement, and the criteria for receiving mesenchymal stem cells.
Closure and Appreciation
The session wraps up with gratitude for participation, a reminder to complete evaluations, and a call to submit feedback. Participants are thanked for their involvement.
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