Graft-versus-host disease.
Haemopoietic-cell transplantation (HCT) is an intensive therapy used to treat high-risk haematological malignant disorders and other life-threatening haematological and genetic diseases. The main complication of HCT is graft-versus-host disease (GVHD), an immunological disorder that affects many organ systems, including the gastrointestinal tract, liver, skin, and lungs. The number of patients with this complication continues to grow, and many return home from transplant centres after HCT requiring continued treatment with immunosuppressive drugs that increases their risks for serious infections and other complications. In this Seminar, we review our understanding of the risk factors and causes of GHVD, the cellular and cytokine networks implicated in its pathophysiology, and current strategies to prevent and treat the disease. We also summarise supportive-care measures that are essential for management of this medically fragile population.
Ferrara
James L M
JL
University of Michigan, Pediatrics and Internal Medicine, Blood and Marrow Transplantation Program, Ann Arbor, MI 48109-5942, USA. ferrara@umich.edu
Levine
John E
JE
Reddy
Pavan
P
Holler
Ernst
E
D000208:Acute Disease; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002908:Chronic Disease; D016207:Cytokines / Q000276:immunology; D005544:Forecasting; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D006650:Histocompatibility Testing; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D010347:Patient Care Planning; D011110:Polymorphism, Genetic; D012307:Risk Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D016207:Cytokines; D007166:Immunosuppressive Agents