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Affecting approximately 50% of allogeneic 異體 hematopoietic stem cell transplantation patients,
and is caused by donated T cells attacking antigens on host cell
Acute graft-versus-host disease : 紅疹 + 腹瀉 (+ 黃疸)
in 100 days after transplant
Rash (most common symptom) : 手腳再到全身
Diarrhea (second most common symptom) : green, mucoid, and watery
Liver (jaundice, hepatitis)
GI bleeding (may be a result of coagulation abnormalities, especially thrombocytopenia)
Prophylaxis : calcineurin inhibitor (e.g., cyclosporine, tacrolimus) with methotrexate
Treatment : PO prednisone or IV methylprednisolone, at 1 - 2 milligrams/kg daily, and possibly adjustment of other immunosuppressant doses
In patients who recover from acute GVHD,
later long-term complications from chronic GVHD are common.
Chronic graft-versus-host disease
late complication characterized by immune dysregulation ( > 100 days after transplantation)
Severe morbidity, with complications affecting
- Skin (sclerodermatous contractures), Muscles (myopathy), Bone (osteoporosis)
- Eyes (keratoconjunctivitis sicca), Nerves (peripheral neuropathy)
- Cardiopulmonary system (physical deconditioning), resembling autoimmune disorders
Post transplant infection : incidence of infection within the first year after transplant of 25-80%.
Fever may be masked by immunosuppressive agents and other factors, such as steroids, uremia, and hyperglycemia
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