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Graft-Versus-Host Disease

Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Tissue destruction in allogeneic hematopoietic stem cell transplant (HSCT) recipients due to donor T cells responding to host (recipient) antigens

  • Two types: acute graft-versus-host d...

DIAGNOSIS

HISTORY

  • GVHD can affect any organ.

  • Most common sites of involvement in aGVHD include skin, GI, and hepatic organs; skin often first involved

  • Additional sites include oral, ocular, pulmonary, an...

TREATMENT

GENERAL MEASURES

  • aGVHD is graded from I (mild) to IV (severe).

  • cGVHD is graded from 0 (mild) to 3 (severe).

MEDICATION

First Line

  • aGVHD of skin

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patients should follow up with their transplant physician, consulting physicians, and supportive care staff. 

Patient Monitoring

  • Nutritional status, including oral ...

REFERENCES

1
Martin PJ, Rizzo JD, Wingard JR, et al. First- and second-line systemic treatment of acute graft-versus-host disease: recommendations of the American Society of Blood and Marrow Transplant...

ADDITIONAL READING

  • Shaw BE. Graft versus host disease clinical trials: is it time for patients centered outcomes to be the primary objective [published online ahead of print January 14, 2019]? Curr He...

CODES

ICD10

  • D89.813 Graft-versus-host disease, unspecified

  • D89.810 Acute graft-versus-host disease

  • D89.811 Chronic graft-versus-host disease

  • D89.812 Acute on chronic graft-versus-host disease

ICD9

  • 279.50 Gr...

CLINICAL PEARLS

  • aGVHD and cGVHD are defined by clinical manifestations. aGVHD occurs early after posttransplant.

  • Skin, GIT, and liver are the common sites involved in aGVHD.

  • The degree of organ involvem...

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