Chronic Graft-vs-Host Disease

ALLOGENEIC HEMATOPOIETIC cell transplantation (HCT) is a treatment used increasingly for a variety of malignant and nonmalignant diseases of the bone marrow and immune system. Although the procedure cures many patients with otherwise incurable diseases, it is often associated with serious immunological complications, particularly graft-vs-host disease (GVHD). A chronic form of GVHD afflicts many allogeneic HCT recipients, resulting in dysfunction of numerous organ systems and an oftentimes profound state of immunodeficiency. Chronic GVHD is the most frequent cause of poor longterm outcome and quality of life after allogeneic HCT. The syndrome typically develops several months after transplantation, when the patient may no longer be under the direct care of the transplant team. The patient’s primary physician plays an important role in diagnosis and treatment of the patient with chronic GVHD.