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Acute Graft-Versus-Host Disease (GVHD)

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Blood and Marrow Transplant Handbook

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Abstract

Despite advances in human leukocyte antigen (HLA) typing, acute graft-versus-host disease (aGVHD) remains a leading cause of morbidity and mortality among allogeneic hematopoietic stem cell transplant (HSCT) recipients. It is estimated that 30–50 % of patients who receive stem cell products from HLA-identical siblings will develop grades 2–4 aGVHD while rates of aGVHD associated with matched unrelated donor transplants are estimated to be between 50 and 70 %.

Early diagnosis with prompt initiation of treatment with high-dose corticosteroids is the key to successful therapy. Tissue pathology is the gold standard for diagnosis; however, sensitivity testing is only approximately 60 %. Between 25 and 40 % of patients will respond to therapy; a majority of patients will require second-line therapy.

Research continues in an effort to identify potential biomarkers to guide the diagnosis and treatment of GVHD, as well as to identify promising first- or second-line agents. This will require ongoing large, multicenter trials with standardized staging/grading of disease, and response criteria.

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Authors and Affiliations

  1. Center for Hematologic Malignancies, Adult Blood and Marrow Stem Cell Transplant Program, Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rodd. UHN 73C, 97239, Portland, OR, USA

    Susan Schubach Slater MN, FNP-BC

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  1. Susan Schubach Slater MN, FNP-BC
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Correspondence to Susan Schubach Slater MN, FNP-BC .

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  1. Knight Cancer Institute Adult Blood and Marrow Stem Cell Transplant Program, Oregon Health & Science University Center for Hematologic Malignancies, Portland, Oregon, USA

    Richard T. Maziarz

  2. Knight Cancer Institute Adult Blood and Marrow Stem Cell Transplant Program, Oregon Health & Science University Center for Hematologic Malignancies, Portland, Oregon, USA

    Susan Schubach Slater

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Slater, S. (2015). Acute Graft-Versus-Host Disease (GVHD). In: Maziarz, R., Slater, S. (eds) Blood and Marrow Transplant Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-13832-9_18

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  • DOI: https://doi.org/10.1007/978-3-319-13832-9_18

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