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Acute Graft-Versus-Host Disease

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Basics of Hematopoietic Stem Cell Transplant

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Abstract

Graft-versus-host disease (GVHD) develops when stem cell graft containing immune cells is transplanted from donor to the recipient resulting in characteristic immune-mediated reactions in the recipient. Acute GVHD is one of the major causes of morbidity and mortality in allogeneic hematopoietic stem cell transplantation (allo SCT). Alloreactive T cells of the donor are involved in the pathophysiology of acute GVHD. They react to the host antigens presented by antigen presenting cells (APCs) to donor T cells. The cytokines released following tissue injury from conditioning regimens further amplify the alloimmune response. Acute GVHD not only damages the skin, liver and gut but also affects the thymus and bone marrow which have significant clinical relevance. First line treatment for acute GVHD consists of corticosteroids. Response to corticosteroids is seen in approximately 50% of patients. Patients with steroid-resistant acute GVHD have a very poor prognosis, with mortality rates in excess of 90%. If GVHD prophylaxis is not used, serious acute GVHD can affect almost every recipient.

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  1. Department of Hemato-oncology and Bone Marrow Transplantation, Venkateshwar Hospital, New Delhi, Delhi, India

    Sanjeev Kumar Sharma

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Sharma, S.K. (2023). Acute Graft-Versus-Host Disease. In: Basics of Hematopoietic Stem Cell Transplant. Springer, Singapore. https://doi.org/10.1007/978-981-19-5802-1_33

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