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- W101030621 abstract "The transplantation of healthy hematopoietic stem cells into a patient with aplastic anemia or leukemia is potentially curative therapy, but the development of acute graftvs-host disease (GVHD), which often occurs even when the donor and recipient are siblings fully matched at the human leukocyte antigen (HLA) loci, significantly limits survival.The first descriptions of acute GVHD, following allogeneic bone marrow transplant (allo-BMT) in humans, were made in the 1960s. Significant strides in prophylaxis of acute GVHD have been made over the past four decades by the use of pharmacologic agents such as methotrexate (MTX) and cyclosporine (CSP), and by manipulation of the donor cell inoculum, to limit the infusion of effector donor lymphocytes. However, given the extensive clinical observations and investigations on the nature of this complication, it is remarkable that the diagnosis of acute GVHD is still clinically challenging, and that this complication continues to pose a formidable obstacle to successful allogeneic hematopoietic stem cell transplantation (allo-HSCT). On the other hand, patients with GVHD have improved leukemia-free survival (the graft-vsleukemia effect [GVL]) and this graft-vs-malignancy effect, a beneficial byproduct of the alloreactivity of the donor cells, may extend to lymphomas, myeloma, and even solid tumors (1–4). Thus, a major question in HSCT biology is how to preserve a graft-vs-malignancy effect, while eliminating GVHD. This chapter reviews some of the critical issues in the clinical manifestations and pathobiology of GVHD, including the results of recent investigations using an in vitro lymphocyte–skin adhesion assay to better define the mechanisms of GVHD. Advances during the past decade, in the prevention and treatment of GVHD, including recent evidence for a role of cellular modulation of GVHD, are also reviewed." @default.
- W101030621 created "2016-06-24" @default.
- W101030621 creator A5036475373 @default.
- W101030621 creator A5064373888 @default.
- W101030621 date "2000-01-01" @default.
- W101030621 modified "2023-09-27" @default.
- W101030621 title "Graft-vs-Host Disease" @default.
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- W101030621 doi "https://doi.org/10.1007/978-1-59259-657-7_17" @default.
- W101030621 hasPublicationYear "2000" @default.
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