On #GVHDDay, I am reflecting on what patients and families have told me they need most after transplant. Their priorities have shaped our research agenda, and this work has only been possible through close collaboration across patients, caregivers, research teams, and partner networks including @nmdp_org @ASTCT @BMTCTN. Our investigator-initiated studies are focused on questions that come directly from the bedside: “Can we prevent chronic #GVHD?” We developed an early protocol version of post-transplant cyclophosphamide in the well-matched myeloablative setting in 2015. When this trial opened, severe acute and chronic graft-versus-host disease rates fell dramatically, signaling a meaningful shift in the field. linkinghub.elsevier.com/retr… “Can we reduce steroid exposure?” We are conducting a first-line dose de-escalation approach for steroids in combination with ruxolitinib and hCG. The study has already moved down to the 0.25 mg/kg cohort, a major step from the historical 2 mg/kg standard. clinicaltrials.gov/study/NCT… “Can you help me regain strength?” In a personalized resistance training study after allogeneic transplant, participants improved muscle mass and immune-related measures. This reinforces the need to expand access to structured strength programs in survivorship care. Manuscript in preparation: clinicaltrials.gov/study/NCT… “Can I get restorative sleep again?” Using Fitbit-based monitoring after inpatient myeloablative transplant, we found that frail and pre-frail patients experienced profound sleep disruption, at times so severe that sleep was barely detectable. These findings underscore the need for better inpatient and early recovery sleep protocols. frontiersin.org/journals/med… “Can we reduce graft-versus-host disease and relapse risk at the same time?” We evaluated a novel post-transplant cyclophosphamide platform with sirolimus plus an Aurora kinase A inhibitor, designed to address both immune toxicity and disease control. Phase I results were recently published. ashpublications.org/bloodadv… “Can we reduce side effects of prevention strategies?” Through analysis of biospecimens from multiple Blood and Marrow Transplant Clinical Trials Network studies, we observed post-transplant cyclophosphamide-associated changes in epidermal growth factor and angiopoietin-2, offering biologic clues to improve supportive care. sciencedirect.com/science/ar… “Can we personalize immunosuppression when diagnosis is uncertain?” When symptoms worsen, distinguishing graft-versus-host disease from infection or other causes is often difficult. Amphiregulin is emerging as a promising blood-based biomarker that may help guide more precise treatment decisions. haematologica.org/article/vi… We have made important progress over the past decade, but patients remind us every day how much work remains. Patient-centered, collaborative research is how we keep moving forward.