GVHD, chronic

Affected Organ Diagnostic Distinctive Other Features6 Common (Seen with Both Acute and Chronic GVHD)... 

Results There was no difference between graft failure and engraftment in the two groups, no significant difference in the incidence of grade II to IV acute GvHD, 43% versus 33% were no difference in chronic GvHD, 38% in both... 

Chronic GvHD was evaluated in patients alive beyond day +80 post transplant and characterized as limited or extensive [14]. 

All data were evaluated and updated as of August 1, 2003. Endpoints of the analysis were transplant-related mortality (TRM), incidence and severity of acute GvHD, incidence and severity of chronic GvHD, incidence of relapse, disease-free survival (DFS) and overall survival (OS). Transplant-related mortality is defined from any cause other than recurrent malignancy. 

One patient in the matched group, who died on the day after bone marrow transplantation, was excluded from the acute GvHD analysis. For chronic GvHD, 128 patients were evaluable in the matched and 37 patients in the mismatched group. 

Previous studies have shown that mismatch of HLA-A, -B and DR leads to an increased incidence of acute and chronic GvHD, and transplant-related... 

Claman, H.N., Choi, K.L., Suiansky, W. and Vatter, A.E. (1986). Mast cell disappearance in chronic murine graft-vs-host disease (GVHD)-ultrastructural demonstration of phantom mast cells . J. Immunol. 137, 2009-2013. 

Jaffee, B.D. and Claman, H.N. (1983). Chronic graft versus host disease (GVHD) as a model for scleroderma. 1. Description of model systems. Cell Immunol. 77, 1-12. 

Pain management. Chronic pain secondary to chronic GVHD needs close monitoring and drug adjustments to attain near complete pain control within 24-48 hours. Monitor patients for chronic toxicities secondary to conditioning regimen immunosuppressive agents. In addition, offer advice on preventive therapies for toxicities and treatment options for toxicities. 

Cytokine-mobilized PBPC transplants from aUogeneic donors have been shown to result in more rapid white ceU and platelet en-graftment and shorter hospital stays than bone marrow transplants. The incidence of acute GVHD is not increased, but there is a significant increase in the incidence of chronic GVHD with PBPC. Relapse rates and overall survival rates are similar with the use of allogeneic PBPC or bone marrow. 

Recipients of HSCT remain at high risk for infection after bone marrow engraftment has occurred. Significant defects in neutrophil function and cell-mediated and humoral immunity, persisting for several months after transplantation, predispose patients to infectious complications. Acute and chronic GVHD also result in prolonged periods of immunosuppression and increased infection rates. 

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