Synonyms
Graft-vs-host disease, GVHD
Definition
GVHD is the result of the activation of donor lymphocytes attacking and damaging the recipient tissues after allogeneic transplant.
Currently, acute and chronic GVHD are defined more along clinicopathologic features rather than time post transplant (previous classifications suggested a breakdown of <100 days for acute GVHD, 100 days for chronic GVHD). Some authors suggest that better terms would be active and active/chronic GVHD.
Clinical Features
Presentation
Gastrointestinal GVHD commonly presents 3 or more weeks after transplant. The classic triad of nausea, vomiting, and diarrhea detected in over 60% of patients represents the most common symptoms. Isolated diarrhea with or without abdominal pain is observed in 20% of patients, while nausea or vomiting without other symptoms is present in only 10% of the cases. Only 7% of GVHD patients experience abdominal pain alone.
Incidence
Autologous GVHD is described in up to 10% of patients...
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References and Further Reading
Cruz-Correa, M., et al. (2002). Endoscopic findings predict the histologic diagnosis in gastrointestinal graft-versus-host disease. Endoscopy, 34(10), 808–813.
Holmberg, L., Kikuchi, K., Gooley, T. A., et al. (2006). Gastrointestinal graft-versus-host disease in recipients of autologous hematopoietic stem cells: Incidence, risk factors, and outcome. Biology of Blood and Marrow Transplantation, 12, 226–234.
Ross, W. A., et al. (2008). Endoscopic biopsy diagnosis of acute gastrointestinal graft-versus-host disease: Rectosigmoid biopsies are more sensitive than upper gastrointestinal biopsies. The American Journal of Gastroenterology, 103(4), 982–989.
Shulman, H. M., et al. (2006). Histopathologic diagnosis of chronic graft-versus-host disease: National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: II. Pathology Working Group Report. Biology of Blood and Marrow Transplantation, 12(1), 31–47.
Thompson, B., et al. (2006). Prospective endoscopic evaluation for gastrointestinal graft-versus-host disease: Determination of the best diagnostic approach. Bone Marrow Transplantation, 38(5), 371–376.
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Liang, WY., Lauwers, G.Y. (2017). Gastric Graft-Versus-Host Disease. In: Carneiro, F., Chaves, P., Ensari, A. (eds) Pathology of the Gastrointestinal Tract. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-40560-5_1627
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DOI: https://doi.org/10.1007/978-3-319-40560-5_1627
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