Canterbury DHB

Context

Introduction

Graft-versus-host disease (GvHD) is the most common complication after allogeneic HCT. It is caused by immunocompetent donor T-lymphocytes. After conventional myeloablative conditioning GvHD occurs primarily in early (acute) and late (chronic) forms. This definition has been of some practical value since the natural history and treatment of acute and chronic GvHD are different. However the introduction of reduced-intensity conditioning has meant that this traditional distinction between acute and chronic GvHD has become blurred. Patients receiving donor lymphocyte infusions may develop an "acute" form several months after transplantation and GvHD with features of the "chronic" form can occur as early as 50 days post transplant.

The recent NIH Consensus Conference suggested two categories of GvHD:

Acute GvHD (absence of features of chronic GvHD), comprising

  1. Classic acute GvHD (before day 100)
  2. Persistent, recurrent or late acute GvHD (after day 100, often upon withdrawal of immunosuppression)

Chronic GvHD

  1. Classic chronic GvHD (diagnostic clinical features must be present)
  2. Overlap syndrome with features of both acute and chronic GvHD

These diagnoses are essentially made on clinical and biopsy criteria.

About this Canterbury DHB document (9067):

Document Owner:

Andrew Butler (see Who's Who)

Issue Date:

December 2016

Next Review:

December 2018

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 9067