Concise review: acute graft-versus-host disease: immunobiology, prevention, and treatment.

Published

Journal Article (Review)

Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplant (AHSCT) associated with significant morbidity and mortality. This review focuses on the pathophysiology, clinical features, prevention, and treatment of acute GVHD. Specifically, we explain how new discoveries in immunology have expanded our understanding of GVHD, in which tissue damage from chemotherapy or radiation results in cytokine release, which activates T cells, resulting in proliferation and differentiation, trafficking to target organs, and tissue destruction and inflammation. Insights into the mechanisms of this disease relate directly to the development of preventive strategies and therapies, such as immunosuppression, T-cell depletion, calcineurin inhibitors, CCR5 antagonists, gut decontamination, extracorporeal photopheresis, and more. We also discuss how GVHD affects the gut, liver, and skin, as well as diagnosis, grading, and scoring. We end by examining future directions of treatment, including new immunomodulators and biomarkers. Understanding the immunobiology of GVHD and developing effective preventions and treatments are critical to the continuing success of AHSCT.

Full Text

Duke Authors

Cited Authors

  • Sung, AD; Chao, NJ

Published Date

  • January 2013

Published In

Volume / Issue

  • 2 / 1

Start / End Page

  • 25 - 32

PubMed ID

  • 23283494

Pubmed Central ID

  • 23283494

International Standard Serial Number (ISSN)

  • 2157-6564

Digital Object Identifier (DOI)

  • 10.5966/sctm.2012-0115

Language

  • eng

Conference Location

  • United States