Graft versus host disease
Acute GVHD (skin, gut, liver; MAGIC grading) and chronic GVHD (NIH diagnostic and distinctive features, bronchiolitis obliterans), prophylaxis with PTCy or ATG, steroids first, ruxolitinib for steroid-refractory disease, and the infections and late effects that kill patients.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- GVHD is donor T cells attacking host tissue after allogeneic haemopoietic stem cell transplant (HSCT). It is the leading non-relapse cause of death after HSCT.
- Acute GVHD hits skin, gut and liver, usually in the first 100 days. Chronic GVHD looks like an autoimmune disease (scleroderma, lichen planus, sicca, bronchiolitis obliterans) and is defined by its features, not timing.
- The same alloreactivity gives the graft-versus-leukaemia effect, so some GVHD comes with lower relapse.
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Sources
- Prophylaxis and management of graft-versus-host disease after stem-cell transplantation for haematological malignancies: updated consensus recommendations of the European Society for Blood and Marrow TransplantationPenack O et al., Lancet Haematol 2024;11:e147-59, 2024
- ANZTCT consensus position statement on ruxolitinib in steroid-refractory acute and chronic graft-versus-host diseaseAU/NZHamad N et al., Intern Med J 2023;53:2319-29, 2023
- Clinical management of acute graft-versus-host disease: an evidence-based review from the ASTCT Committee on Practice GuidelinesDeFilipp Z et al., Transplant Cell Ther 2026;32:1057-72, 2026
- National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. The 2014 Diagnosis and Staging Working Group reportJagasia MH et al., Biol Blood Marrow Transplant 2015;21:389-401, 2014
- NIH Chronic Graft-Versus-Host Disease Consensus Conference 2025 UpdateLee SJ et al., Transplant Cell Ther 2025;31:678.e1-16, 2025
- International, multicenter standardization of acute graft-versus-host disease clinical data collection: a report from the MAGIC consortiumHarris AC et al., Biol Blood Marrow Transplant 2016;22:4-10, 2016
- Ruxolitinib for glucocorticoid-refractory acute graft-versus-host disease (REACH2)Zeiser R et al., N Engl J Med 2020;382:1800-10, 2020
- Ruxolitinib for glucocorticoid-refractory chronic graft-versus-host disease (REACH3)Zeiser R et al., N Engl J Med 2021;385:228-38, 2021
- Post-transplantation cyclophosphamide-based graft-versus-host disease prophylaxis (BMT CTN 1703)Bolaños-Meade J et al., N Engl J Med 2023;388:2338-48, 2023
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy