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Acute Graft Versus Host Disease: Prophylaxis

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Allogeneic Stem Cell Transplantation

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

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Abstract

Acute GVHD remains one of the most significant barriers to successful allogeneic stem cell transplantation, accounting for a substantial portion of early transplant-related morbidity and mortality. Acute GVHD results from the complex interaction of donor T cells and host tissues that involves recognition of major and minor histocompatibility antigens in an inflammatory milieu. The pathophysiology of acute GVHD involves both the innate and adaptive immune systems and follows the orderly cycle of host tissue damage (from conditioning or other injury), donor T cell activation and clonal expansion, followed by cellular and inflammatory factor-induced tissue injury [1]. While all three components are critical, it is only the cellular attack on host tissues that is currently specifically targeted by GVHD prophylactic mechanisms, either with the use of a variety of pharmacologic agents or graft manipulation techniques. Other strategies to reduce acute GVHD (such as non-myeloablative or reduced intensity transplantation) may independently reduce the risk of acute GVHD via a reduction in host tissue damage from conditioning.

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  1. Harvard Medical School and Dana Farber Cancer Institute, Boston, MA, USA

    Corey Cutler, Vincent T. Ho & Joseph H. Antin

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  1. Corey Cutler
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  2. Vincent T. Ho
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  1. University Hospitals Case Medical Center, Cleveland, OH, USA

    Hillard M. Lazarus

  2. Case Western Reserve University, Cleveland, OH, USA

    Mary J. Laughlin

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Cutler, C., Ho, V.T., Antin, J.H. (2010). Acute Graft Versus Host Disease: Prophylaxis. In: Lazarus, H.M., Laughlin, M.J. (eds) Allogeneic Stem Cell Transplantation. Contemporary Hematology. Humana Press. https://doi.org/10.1007/978-1-59745-478-0_32

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