BMTCN Review Chapter 5 - Graft-Versus-
Host Disease Exam 2023/2024
GVHD - ANSWER-Competent donor t-cells recognize antigens, mount immune response, and and attack recipient organs
Classifications of GHVD - ANSWER-Acute
Chronic
Hyperacute
Overlap Syndrome
Acute GVHD - ANSWER-Generally occurs within first 100 days or nor meeting chronic criteria
Presents as erythematous, maculopapular rash, nausea, vomiting, anorexia, profuse diarrhea, ileus, or cholestatic liver
Chronic GVHD - ANSWER-Has manifestations of autoimmune disease and no charaacteristics of acute GVHD
Involves multiple organs (skin, eyes, oral mucosa, ling, GI tract, liver)
Usually diagnosed within the first year
Median onset 4-6 months MOST FREQUENT OCCURRENCE IN FIRST YEAR
Hyperacute GHVD - ANSWER-Can be fatal
Fever greater than 38.3 C on two occasions or for more than 3 days prior to engraftment with lack of resolution after minimum of 3 days with abx and antifungal agents
rapid development of rash
Hepatic dysfuntion
More than 5 stools per day of mucoid green diarrhea
High dose steroid treatment
Difficult to differentiate with engraftment syndrome
Overlap Syndrome - ANSWER-Features of acute and chronic appear at the same time
Incidence of GVHD - ANSWER-Grades 2-4, 20-85%
Risk factors (Acute and Chronic) - ANSWER-Most important: degree of HLA mismatch
Graft source
Gender mismatch (greatest: parous female donor to male recipient)
Donors over age 40 High dose TBI
Conditioning intensity
Higher CD34+ cell count
Prophylaxis
Unmanipulated graft (t-cell depletion)
Donor transfusion status
Related vs unrelated (best: HLA mathced sibling)
Pathophysiology Phase 1 - ANSWER-Occurs prior to transplant when preparative regimen may damage host (GI, skin, liver)
Permeable mucosa leads to secretion of inflammatory cytokines
Cytokines upregulate major histocompatibility complexes and minor histocompatibility antigens (host)
Mature T cells (donor) recognize upregulated recipient tissue as foreign and mount an immunologic response
Pathophysiology Phase 2 - ANSWER-Donor T cell activation
Donor T cells come into contact with minor antigens on recipients cells blood stream
Some donor T cells recognize antigens as foreign and bind them
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Bensuda. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.49. You're not tied to anything after your purchase.
