Transfusion-associated graft-versus-host disease: an overview and two case reports.
OBJECTIVE
To describe the pathogenesis, clinical manifestations, and diagnosis of transfusion-associated graft-versus-host disease (TA-GVHD) and to illustrate these concepts using two case reports.


METHODS
Published articles, books, and the author's clinical experience.


RESULTS
Graft-versus-host disease (GVHD) is most commonly associated with allogeneic bone marrow transplantation (BMT). However, GVHD increasingly is being reported in the non-BMT population. Of particular concern is TA-GVHD, an underrecognized, usually life-threatening complication of supportive care in both immunosuppressed as well as immunocompetent hosts.


CONCLUSIONS
Most cases of TA-GVHD may be prevented with the use of irradiated blood products.


CONCLUSIONS
Nurses can have a positive impact on the prevention of this highly morbid disease. Thorough assessment, education, and supportive care are essential when caring for patients with TA-GVHD. Because of ineffective treatment strategies, is-sues surrounding death and dying cannot be overlooked.
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Cancer Pain Services, Mt. Sinai Comprehensive Cancer Center, Miami Beach, FL.
D017809:Fatal Outcome; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology* / Q000451:nursing; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D065227:Transfusion Reaction