Graft-versus-host disease

Summary 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...

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Bibliographic Details
Published in:The Lancet (British edition) 2009-05, Vol.373 (9674), p.1550-1561
Main Authors: Ferrara, James LM, Prof, Levine, John E, Prof, Reddy, Pavan, MD, Holler, Ernst, Prof
Format: Article
Language:English
Subjects:
Acute Disease
Anti-Inflammatory Agents - therapeutic use
Apoptosis
Biological and medical sciences
Blood pressure
Blood products
Bone density
Chronic Disease
Chronic illnesses
Cytokines - immunology
Disease
Forecasting
Gastrointestinal tract
General aspects
Graft vs Host Disease - diagnosis
Graft vs Host Disease - epidemiology
Graft vs Host Disease - etiology
Graft vs Host Disease - prevention & control
Hematology
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic Stem Cell Transplantation - statistics & numerical data
Histocompatibility Testing
Humans
Immunity, Cellular - immunology
Immunosuppressive Agents - therapeutic use
Internal Medicine
Medical sciences
Mortality
Patient Care Planning
Patients
Polymorphism, Genetic
Risk Factors
Skin
Transplantation Conditioning
Transplantation, Homologous
Transplants & implants
Treatment Outcome
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Summary:Summary 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.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(09)60237-3