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CME: Contemporary treatment approaches in the management of graft-versus-host disease (GVHD)

Activity Description / Statement of Need:

In this online, self-learning activity:

Graft-versus-host disease (GvHD) is an immune-mediated response that occurs in recipients of allogenic hematopoietic cell transplantation (HCT). GvHD can be further categorized into acute and chronic cases. Maculopapular rash, follicular erythema, epidermolysis, are common manifestations of acute GvHD, in addition to liver and gastrointestinal dysfunction such as hyperbilirubinemia, nausea, and diarrhea. This activity focuses on chronic GvHD, which has more extensive multi-organ involvement including the liver, eyes, mouth, lungs, skin, genitalia, and gastrointestinal tract.

Target Audience:

The following HCPs: hematologists and oncologists; nurse practitioners, physician assistants, and pharmacists who specialize in oncology; and those who otherwise commonly care for or clinically encounter patients with GVHD.

Commercial Support Disclosure: This program is supported by an educational grant from Mallinckrodt.

This activity is free of charge.

Release Date: March 31, 2023 -- Expiration Date: March 31, 2025

Faculty: Catherine Lee, MD


Faculty introduction and disclosures 

Introductory content 

  • Epidemiology  
  • Pathophysiology, clinical presentation, and recognition 
  • aGvHD vs cGvHD 
  •  Treatment of cGvHD
      • Goals of therapy and prognosis 
      • Overlap syndrome 
      • Disease severity 
      • Corticosteroid therapy and related treatment success vs. failure 
      • Steroid-refractory disease: definitions and therapies 
          • JAK inhibition 
          • Rho-associated kinase inhibition 
          • Calcineurin inhibition 
          • Non-pharmacologic treatment approaches 
            • Extracorporeal photopheresis 
            • Psoralen ultraviolet radiation 
          • Emerging therapies 
            • Alpha-1 proteinase inhibition 
            • α4β7-integrin inhibition 
            • Additional agents targeting tyrosine kinase 
      • Monitoring 
      • Site-specific considerations 
  • Clinical challenges: adherence, adverse effects, delays in therapy  
  • Patient cases 

Summary, conclusions, and best practice recap  

Learning Objectives

By the end of the session the participant will be able to:

  • Review the epidemiology and pathophysiology of cGVHD.
  • Describe the diagnostic and staging criteria in cGVHD.
  • Discuss recent FDA-approved therapeutic agents for treatment refractory cGVHD.
  • Formulate treatment plan for a patient with cGVHD.
  • Describe the role of supportive care in cGVHD management.


ACCME Activity #202490640

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.


ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-23-016-H01-P. This is an Application (A) type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosure of Faculty: Catherine Lee, MD, Associate Professor of Medicine, Fred Hutch Cancer Center, has received financial compensation from Incyte, Kite pharma, BMS, Kadmo, CareDx, and Fresnius Kabi for consulting and/or research and/or speaker's bureau work.


Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty will NOT discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Mallinckrodt.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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