Graft-versus-host disease occurs when donor immune cells attack a transplant recipient's tissues, most often after stem cell or bone marrow transplant. It affects about half of transplant recipients and ranges from mild skin rashes to severe damage of skin, liver, gut, and other organs. Treatment focuses on dampening the immune attack without losing the transplant's cancer-fighting benefit.
What's actually going on in research
Trials are testing JAK inhibitors like ruxolitinib (FDA-approved for steroid-refractory acute GVHD in 2019), BTK inhibitors that calm B cells, drugs that preserve regulatory T cells, and treatments targeting specific inflammatory proteins like IL-6. Researchers are also studying ways to prevent GVHD before it starts, including removing certain immune cells from donor grafts and using low-dose medications early after transplant.
JAK inhibitors
Ruxolitinib blocks JAK1 and JAK2 enzymes that drive inflammation and is now standard for steroid-resistant acute GVHD. Trials are testing whether earlier use or newer JAK inhibitors work better.
Regulatory T cell therapies
These specialized immune cells suppress overactive responses. Trials are testing whether giving patients extra regulatory T cells from donors can prevent GVHD without weakening the transplant's effect against cancer.
Targeted antibodies
Drugs that block specific immune signals like IL-6 or alpha-4-beta-7 integrin are being tested for chronic GVHD affecting gut and other organs. These aim to shut down inflammation more precisely than steroids.
What to know before you search
Eligibility depends on whether GVHD is acute or chronic, which organs are affected, response to prior treatments like steroids, and time since transplant.
What types of trials are currently open
- Prevention trials — Testing medications or graft modifications given before or soon after transplant to reduce the chance GVHD will develop.
- Treatment trials — Testing new drugs for acute or chronic GVHD, often in people whose disease hasn't responded to steroids.
- JAK inhibitor trials — Studies of ruxolitinib and newer JAK inhibitors, testing whether they work for different GVHD types or stages.
- Cell therapy trials — Testing infusions of regulatory T cells or mesenchymal stromal cells to calm the immune system.
- Quality of life studies — Following transplant recipients to understand how GVHD affects daily function, symptoms, and long-term health.
Recently added Graft Versus Host Disease trials
Track eye health changes after your stem cell transplant
This study is a multicenter, prospective, observational cohort study designed to enroll a total of 340 patients undergoing allogeneic hematopoietic stem cell transplantation. Through comprehensive evaluations by hematology departments, ophthalmology departments, and patient-reported outcomes, the study aims to assess patient-reported outcomes, overall incidence, risk factors, and other clinical outcomes in patients with chronic ocular graft-versus-host disease following allogeneic hematopoietic stem cell transplantation.
Take a stomach protection medication after stem cell transplant
The goal of this clinical trial is to observe whether different gastric protection strategies affect the incidence of acute graft-versus-host disease (aGVHD) in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Proton pump inhibitors (PPIs) are routinely used for gastric protection during transplantation, but their prolonged use may suppress gastric acid, alter gut microbiota, and potentially increase the risk of aGVHD. Teprenone, a gastric mucosal protective agent (GMPA), enhances mucosal defense mechanisms including promoting mucus secretion, increasing gastric mucosal blood flow, and facilitating epithelial cell repair, without affecting gastric acid secretion, and may therefore preserve microbial diversity and modify aGVHD risk. This study compares two strategies: continuous PPI use versus switching from PPIs to teprenone after transplantation. The main questions this study aims to answer are: * Does switching from PPIs to teprenone after transplantation reduce the cumulative incidence of aGVHD within +100 days post-transplantation compared with continuous PPI use? * What adverse events do participants experience with teprenone versus continuous PPI therapy? * Does teprenone therapy provide better preservation of gut microbial diversity and lower rates of gastrointestinal and infectious complications compared with continuous PPI use? In this prospective, randomized, parallel-controlled, single-center trial, approximately 198 patients undergoing allo-HSCT will be enrolled and assigned in a 1:1 ratio using a central randomization system. The experimental group (teprenone group) will receive standard-dose PPIs (esomeprazole, 40 mg/d, intravenous/oral) during conditioning and switch to teprenone (50 mg tid, orally) after transplantation through day +100. The control group (PPI group) will receive continuous standard-dose PPIs from conditioning through day +100. Probiotic use is prohibited from conditioning through day +100 in both groups. All other anti-infective, GVHD prophylaxis, and supportive care regimens are identical between the two groups. The primary endpoint of this study is the cumulative incidence of aGVHD within +100 days post-transplantation. Secondary endpoints include grade II-IV and grade III-IV aGVHD, lower gastrointestinal aGVHD, steroid-refractory aGVHD, gut and salivary microbiome dynamics (α-diversity, β-diversity, and specific taxa at pre-conditioning, day 0, day +14, and day +28), plasma biomarkers related to intestinal barrier integrity, systemic inflammation, and immune regulation , infectious and gastrointestinal complications (febrile neutropenia, diarrhea, C. difficile infection, bacteremia, EBV/CMV reactivation, upper GI bleeding, reflux), and 1-year survival outcomes (non-relapse mortality, overall survival, GVHD-free/relapse-free survival). During the study, participants will: * Receive the assigned gastric protection regimen (teprenone or PPI) according to randomization * Undergo regular assessments for safety and efficacy monitoring, including aGVHD surveillance and infection screening * Provide fecal and saliva samples at pre-conditioning, day 0, day +14, and day +28 post-transplantation for microbiome analysis * Provide peripheral blood samples at pre-conditioning, day 0, day +14, and day +28 post-transplantation for exploratory analysis * Be followed for up to 1 year post-transplantation
Find Graft Versus Host Disease trials matched specifically to you
Answer 3 quick questions and we'll show you trials that fit your situation.