Graft versus host disease

Keywords: GVHD

Manifestations

Appropriate Tests

Acute

Caused by donor-derived (allograft or blood transfusion) lymphocytes reacting against recipient tissues, usually following haemopoietic stem cell allo-transplantation.

These lymphocytes originate from the stem cell graft, or from non-irradiated blood products. Also refer to Transfusion-associated GVHD, see Blood transfusion.

Occurs up to 100 days following transplantation.

Skin rashes

Skin biopsy (affected area).

Erythroderma

 

Hepatitis

Bilirubin, Aspartate aminotransferase, Alanine aminotransferase, Alkaline phosphatase, Gamma glutamyltransferase, Liver biopsy if indicated and clinically appropriate.

Diarrhoea

Colorectal biopsy may be indicated.

See Diarrhoea - chronic

Abdominal pain

 

Pancytopenia

Full blood count; Bone marrow aspirate and trephine may be indicated.

Chronic

Occurring more than 100 days after transplantation.

Skin rash

Skin biopsy (affected area) may be indicated.

Malabsorption

Small bowel biopsy, if indicated.

Hyposplenism

Full blood count.

See Splenic atrophy/absence.

Bronchiolitis obliterans

 

Scleroderma-like syndrome

 

Sicca syndrome

 

Cataracts

 

Alopecia