Graft vs. host disease: pathology, prophylaxis and therapy GVHD overview.

摘要

The dominant complication limiting the effectiveness and safety of allogeneic hematopoieticcell transplantation (HCT) is graft vs. host disease (GVHD). It induces early peritransplant morbidity from organ toxicity and infection and is the most common cause of late non-relapse mortality. The hazards of acute and chronic GVHD must be addressed through prophylaxis, evaluation and therapy in all allotransplants. In this volume, we review numerous aspects of its experimental and clinical pathophysiology. The target organs, cellular tissues and molecular pathogenesis of the syndromes are highlighted to distinguish important known and still unknown differences between acute and chronic GVHD. Additionally, its prophylaxis, clinical epidemiology and impact on survival following conventional transplants and after cellular lymphoid infusions are described. Though not fully based in pathophysiology and not grounded in high-quality evidence, both conventional and new treatments for acute GVHD and the divergence of GVHD from the favorable therapeutic anti-tumor effects of an allograft are discussed.