Book contents
- Frontmatter
- Contents
- Acknowledgments
- Contributor
- 1 Rationale for transplantation
- 2 Types of transplantation
- 3 Human leukocyte antigen matching in allogeneic transplantation
- 4 Stem cell source
- 5 Pretransplant evaluation and counseling of patient and donor
- 6 Conditioning regimens
- 7 Stem cell infusion
- 8 ABO compatibility
- 9 Engraftment
- 10 Preventative care
- 11 Transplant-related complications
- 12 Overview of acute and chronic graft-versus-host disease
- 13 Acute graft-versus-host disease and staging
- 14 Graft-versus-host disease prophylactic regimens
- 15 Treatment guidelines for acute graft-versus-host disease
- 16 Chronic graft-versus-host disease
- 17 Engraftment syndrome
- 18 Infectious disease
- 19 Graft rejection and failure
- 20 Gastrointestinal complications
- 21 Oral health in stem cell transplantation
- 22 Pulmonary complications
- 23 Veno-occlusive disease
- 24 Special transfusion-related situations
- 25 Cardiovascular complications
- 26 Neurologic complications
- 27 Cystitis
- 28 Donor lymphocyte infusion
- 29 Transplantation: regulation and accreditation
- Index
13 - Acute graft-versus-host disease and staging
Published online by Cambridge University Press: 05 November 2013
- Frontmatter
- Contents
- Acknowledgments
- Contributor
- 1 Rationale for transplantation
- 2 Types of transplantation
- 3 Human leukocyte antigen matching in allogeneic transplantation
- 4 Stem cell source
- 5 Pretransplant evaluation and counseling of patient and donor
- 6 Conditioning regimens
- 7 Stem cell infusion
- 8 ABO compatibility
- 9 Engraftment
- 10 Preventative care
- 11 Transplant-related complications
- 12 Overview of acute and chronic graft-versus-host disease
- 13 Acute graft-versus-host disease and staging
- 14 Graft-versus-host disease prophylactic regimens
- 15 Treatment guidelines for acute graft-versus-host disease
- 16 Chronic graft-versus-host disease
- 17 Engraftment syndrome
- 18 Infectious disease
- 19 Graft rejection and failure
- 20 Gastrointestinal complications
- 21 Oral health in stem cell transplantation
- 22 Pulmonary complications
- 23 Veno-occlusive disease
- 24 Special transfusion-related situations
- 25 Cardiovascular complications
- 26 Neurologic complications
- 27 Cystitis
- 28 Donor lymphocyte infusion
- 29 Transplantation: regulation and accreditation
- Index
Summary
Acute graft-versus-hostdisease (GVHD) occurs when donor T cells recognize host antigens as foreign,resulting in T-cell lymphocyte stimulation (antigen presentation, T-cellactivation, and T-cell proliferation) and T-cell and secondary effector cellresponse (cytokine secretion, cytotoxic T cells, natural killer [NK] cells).Contribution of specific subsets remains uncertain. In murine systems, NKcells play a role in GVHD development. The development of acute GVHD (aGVHD)may be triggered by the initial tissue damage from the conditioning regimen,which releases inflammatory cytokines such as γ-interferon, IL-1, and tumornecrosis factor (TNF). Risk factors for aGVHD include disparity at class Ior class II HLA loci, female donor → male recipient, older patient age,older donor age, multiparous female donor, and herpes simplex virus (HSV) orcytomegalovirus (CMV) seropositivity. Patients who develop aGVHD are athigher risk for developing chronic GVHD (cGVHD).
As noted earlier, aGVHD canbe classic or late-onset. Acute GVHD is characterized by skin,gastrointestinal (GI) tract, and/or hepatic involvement.
- Type
- Chapter
- Information
- Manual of Stem Cell and Bone Marrow Transplantation , pp. 50 - 52Publisher: Cambridge University PressPrint publication year: 2013