Abstract:
Chronic graft-versus-host disease (cGVHD) is a major challenge affecting the long-term survival of patients after allogeneic hematopoietic stem cell transplantation, especially for those who are resistant to glucocorticoid. In recent years, cell therapy, as an "active drug", has brought breakthroughs in the treatment of cGVHD by actively regulating immunity rather than using traditional broad-spectrum immunosuppression. Mesenchymal stem cells have shown potential in reducing the incidence of cGVHD and treating refractory patients, but their efficacy is affected by the cell source and heterogeneity; regulatory T cell (Treg) has performed outstandingly in restoring immune tolerance and are gradually evolving towards antigen-specific and chimeric antigen receptor (CAR)-Treg in a precise direction; in addition, CAR-T cell therapies targeting pathogenic B cell, plasma cell, or fibroblast, as well as novel strategies such as regulatory B cell and myeloid-derived suppressor cell, have further expanded the treatment options. Despite challenges such as product standardization, efficacy prediction and cost, in the future, through the integration of combination therapy, universal products and genetic engineering technologies, cell therapy is expected to drive cGVHD towards an individualized and precise treatment era.