Graft-versus-host disease natural history, complications and prognosis
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Graft-versus-host disease |
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Differentiating Graft-versus-host disease from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
Overview
Natural History
Complications
- Infections: A major complication of GvHD is the resulting immunosuppression that occurs after treatment. Treatment of GvHD focuses on abrogating the abnormal immune activation, and high dose steroids are typically administered. Late fungal infections and Pneuomocystis carinii are common in patients who develop GvHD and receive treatment with immunosuppressive agents.[1]
- Non-malignant late complications: These include ophthalmic, skeletal, joint, cardiovascular impairment.[1]
- Malignant complications: These include squamous cell carcinoma of the head and neck (due to HPV infection), squamous cell carcinoma of the skin, and other immunosuppression-associated malignancy like hematolyphoid malignancies.[1]
Prognosis
A few different prognostic classifications have been developed for GvHD.[1]
- Johns Hopkins Hospital
- Center for International Blood and Marrow Transplant Research
- NIH consensus classification: This classification proposes a global chronic severity score and includes the degree to which different organs are involved.
Prognostic factors include:
- Thrombocytopenia with platelet count less than 100000 per microliter[1]