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Graft-versus-host disease: implications from basic immunology for prophylaxis and treatment

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Blood Stem Cell Transplantation

Part of the book series: Cancer Treatment and Research ((CTAR,volume 77))

Abstract

Graft-vs.-host disease (GVHD) continues to be a major complication after allogeneic bone marrow transplantation, especially with the increasing use of unrelated and mismatched donors. To understand how best to prevent GVHD and to treat GVHD should prophylaxis fail, it is necessary to have a good understanding of the underlying immunology of GVHD. There has been recent progress in understanding two basic aspects of the immune response in GVHD — the immunologic target and the effector mechanisms. First, the target of the immune response in GVHD has been identified as histocompatibility antigens possessed by the host but not the donor. Recognition of self antigens in GVHD has been documented, showing that GVHD is more than simple alloreactivity. Second, the effector mechanism in GVHD was initially thought to be direct cytotoxicity by alloreactive T cells. Cytokines are now known to play a central role in mediating many of the clinical and experimental manifestations of GVHD.

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Authors
  1. Georgia B. Vogelsang
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Editors and Affiliations

  1. Bone Marrow Transplant Program, Robert H. Lurie Cancer Center, Northwestern Memorial Hospital and Northwestern University, Chicago, Illinois, 60611, USA

    Jane N. Winter M.D.

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Vogelsang, G.B. (1997). Graft-versus-host disease: implications from basic immunology for prophylaxis and treatment. In: Winter, J.N. (eds) Blood Stem Cell Transplantation. Cancer Treatment and Research, vol 77. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6349-5_4

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  • DOI: https://doi.org/10.1007/978-1-4615-6349-5_4

  • Publisher Name: Springer, Boston, MA

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