The Biology of Chronic Graft-Versus-Host Disease
Chronic graft-versus-host (GVHD) disease occurs in as many as 30–50% of long-term survivors after allogeneic marrow transplantation, even when the donor was an HLA genotypically identical sibling (1, 2). Because of severe morbidity and mortality associated with this syndrome, it has a major effect on long-term results of clinical marrow transplantation (3). Chronic GVHD generally develops within 3 months to one year after transplantation. Three forms of onset have been recognized (4): 1) Progressive chronic GVHD, i.e. as a continuation of acute GVHD, 2) quiescent chronic GVHD, i.e. after a disease-free, asymptomatic interval following acute GVHD, and 3) de novo chronic GVHD in patients who never had any clinical manifestation of acute GVHD. The prognosis is the worst for patients with progressive chronic GVHD, intermediate with quiescent, and best with de novo chronic GVHD.
KeywordsAnemia Cyclosporine Thrombocytopenia Prednisone Esophagitis
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