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Stem Cell Transplantation for Hematologic Malignancies pp 185–200Cite as

Chronic Graft-vs-Host Disease After Transplantation

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Part of the book series: Contemporary Hematology ((CH))

Abstract

Chronic graft-vs-host disease (GVHD) is one of the most common and significant problems affecting long-term survivors of allogeneic bone marrow transplantation (a11oBMT). Despite recent and ongoing advances in the treatment of acute GVHD, the incidence of chronic GVHD continues to rise. Factors associated with this increase include changes in patient demographics and changes in transplant procedures. As our ability to support patients through a11oBMT improves, older patients who are at an increased risk for chronic GVHD are undergoing transplantation. Furthermore, whereas vigorous T-cell depletion was employed in recent decades, most centers have moved away from this method of GVHD prophylaxis because it has been associated with higher rates of graft failure and relapse and no improvement in overall survival (OS) (1). Alternative donors, including unrelated donors mismatched at a single human lymphocyte antigen (HLA) allele and haplo-identical related donors, are being used with increasing frequency in the nonmyeloablative transplant setting and in pediatric patients. Additionally, the use of donor lymphocyte infusion (DLI) to prevent or to treat disease relapse is contributing the higher rates of chronic GVHD. Finally, although peripheral blood stem cell transplant (PBSCT) has resulted in equivalent or reduced rates of acute GVHD, most trials have shown that the incidence of chronic GVHD in this setting is increased (2).

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Authors
  1. Georgia B. Vogelsang MD
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  2. Colleen H. McDonough MD
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Editor information

Editors and Affiliations

  1. Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Robert J. Soiffer MD

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© 2004 Springer Science+Business Media New York

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Vogelsang, G.B., McDonough, C.H. (2004). Chronic Graft-vs-Host Disease After Transplantation. In: Soiffer, R.J. (eds) Stem Cell Transplantation for Hematologic Malignancies. Contemporary Hematology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-733-8_8

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  • DOI: https://doi.org/10.1007/978-1-59259-733-8_8

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-6588-5

  • Online ISBN: 978-1-59259-733-8

  • eBook Packages: Springer Book Archive

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