acute graft versus host disease


Also found in: Acronyms.

acute graft versus host disease

A distinctive syndrome of dermatitis, hepatitis, and enteritis developing within 100 days of allogeneic haematopoietic (stem) cell transplantation. Acute GVHD occurs in up to 2/3 of HLA-identical siblings and is increasingly common as HLA mismatching increases, and occurs in 80% of marrow recipients.
 
Clinical findings
• Hyperacute GVHD—fever, generalised erythroderma, desquamation with 2 weeks of transplantation.
• Acute GVHD—pruritic or painful rash, elevated liver enzymes with cholestatic jaundice; GI tract involvement is associated with diarrhoea, bleeding, painful bloating, and ileus.

Complications
Acute GVHD carries an increased risk of pneumonia and sterile effusions, hemorrhagic cystitis, thrombocytopenia, and anaemia.
 
Diagnosis
Lab—autoimmune cytopaenias, increased alkaline phosphatase, cholestasis, hypoalbuminaemia due to GVHD-associated leakage of protein into the gut, negative nitrogen balance, electrolyte imbalance due to diarrhoea.

Management
Primary prophylaxis with cyclosporin A (CSA), methotrexate, antithymocyte globulin (ATG). If Acute GVHD develops, corticosteroids, increase dose of CSA, add tacrolimus, ATG, and various monoclonal antibodies—none of which have proven clearly superior.
References in periodicals archive ?
MELBOURNE, Australia, March 7, 2016 -- Mesoblast Limited (MESO) said study results presented at two scientific meetings in Hawaii showed that use of its proprietary Tier 1 mesenchymal stem cell product candidate remestemcel-L (MSC-100-IV) demonstrated clinically meaningful responses and significantly increased survival in children with steroid-refractory acute Graft Versus Host Disease (aGvHD).
The primary end points include acute graft versus host disease (aGVHD) during the first 100 days and safety.
Highlights include reports on the potential therapeutic market expansion of Thymoglobulin (Anti-thymocyte Globulin, (Rabbit)), through SangStat's clinical development program which now has over 200 patients enrolled in a variety of trials, and on the ABX-CBL patient trial for the treatment of acute graft versus host disease, with now over one third of patients (35) already enrolled.
a licensee of Australia's Mesoblast Limited (MESO), has launched the mesenchymal stem cell product TEMCELLfor the treatment of acute graft versus host disease (aGvHD) in children and adults in Japan.
The risk of developing grade II-IV acute graft versus host disease (GVHD) increased from 38% in the children receiving standard cyclosporine doses to 57% in those given the lower dose of the drug.
JR-031 is a treatment for acute graft versus host disease (GVHD), a severe complication arising from hematopoietic cell transplants.

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