Wednesday, 23 November 2011

Graft versus host disease

- common complication after stem cell or bone marrow transplantation
- donor cells against normal host organs
- Billingham criteria - 3 criteria must be met in order for GVHD to occur
  i) immunocompetent graft is administered with viable and functional immune cells
  ii) recipient is immunologically disparate - histo-incompatible
  iii) recipient is immunocompromised, therefore cannot inactivate or destroy the transplanted cells
- can be divided into acute (within first 100 days post-transplantation) or chronic
- onset of acute GVHD is usually from day 16 - day 20 as donor marrow engrafts and the neutrophils count rises
- acute GVHD causes a skin rash (typically commencing on palms and soles), diarrhea and jaundice
- more common after unrelated donor transplantation
- initial treatment of acute GVHD is high dose methylprednisolone. If no response, consider antilymphocyte globulin

2 comments:


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  2. Great post, much appreciate the time you took to write this

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