Acute graft-versus-host disease: Pathophysiology, clinical manifestations, and management

Daniel Couriel, Humberto Caldera, Richard Champlin, Krishna Komanduri

Research output: Contribution to journalReview article

149 Scopus citations

Abstract

Hematopoietic stem cell transplantation has evolved as a central treatment modality in the management of different hematologic malignancies. Despite adequate posttransplantation immunosuppressive therapy, acute graft-versus-host disease (GVHD) remains a major cause of morbidity and mortality in the hematopoietic stem cell transplantation setting, even in patients who receive human leukemic antigen (HLA) identical sibling grafts. Up to 30% of the recipients of stem cells or bone marrow transplantation from HLA-identical related donors and most patients who receive cells from other sources (matched-unrelated, non-HLA-identical siblings, cord blood) will develop > Grade 2 acute GVHD despite immunosuppressive prophylaxis. Thus, GVHD continues to be a major limitation to successful hematopoietic stem cell transplantation. In this review, the authors summarize the most current knowledge on the pathophysiology, clinical manifestations, and management of this potentially life-threatening transplantation complication.

Original languageEnglish (US)
Pages (from-to)1936-1946
Number of pages11
JournalCancer
Volume101
Issue number9
DOIs
StatePublished - Nov 1 2004
Externally publishedYes

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Keywords

  • Hematopoietic stem cell transplantation
  • Immunosuppressive therapy
  • Inflammatory cytokines
  • T-cell subsets

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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