Book contents
- Frontmatter
- Contents
- List of Contributors
- Preface
- PART I GENERAL PRINCIPLES
- PART II CLINICAL MANAGEMENT
- 9 Diagnosis and Staging
- 10 Chronic Graft versus Host Disease Pharmacology
- 11 Prevention of Chronic Graft versus Host Disease
- 12 Front Line Treatment of Chronic Graft versus Host Disease
- 13 Salvage Therapy in Chronic Graft versus Host Disease
- 14 Evaluating Therapeutic Response in Chronic Graft versus Host Disease
- 15 General Principles of Ancillary and Supportive Care
- PART III ORGAN SITE OR SYSTEM-SPECIFIC MANIFESTATIONS
- PART IV SPECIAL CONSIDERATIONS IN CHRONIC GVHD
- Index
- Plate section
9 - Diagnosis and Staging
from PART II - CLINICAL MANAGEMENT
Published online by Cambridge University Press: 26 August 2009
- Frontmatter
- Contents
- List of Contributors
- Preface
- PART I GENERAL PRINCIPLES
- PART II CLINICAL MANAGEMENT
- 9 Diagnosis and Staging
- 10 Chronic Graft versus Host Disease Pharmacology
- 11 Prevention of Chronic Graft versus Host Disease
- 12 Front Line Treatment of Chronic Graft versus Host Disease
- 13 Salvage Therapy in Chronic Graft versus Host Disease
- 14 Evaluating Therapeutic Response in Chronic Graft versus Host Disease
- 15 General Principles of Ancillary and Supportive Care
- PART III ORGAN SITE OR SYSTEM-SPECIFIC MANIFESTATIONS
- PART IV SPECIAL CONSIDERATIONS IN CHRONIC GVHD
- Index
- Plate section
Summary
INTRODUCTION
Chronic graft versus host disease (cGVHD) is an alloreactive phenomenon that often complicates allogeneic stem cell transplantation (SCT). Significant progress has been made in acute graft versus host disease (aGVHD) prophylaxis and management. Similar progress in cGVHD has been elusive due to multiple factors, including lack of well defined and prognostically validated classification. This in turn leads to enrollment of a heterogeneous spectrum of cGVHD patients on clinical trials and confounds accurate interpretation of the outcome. Lack of appropriate animal models and the true pathogenesis of this clinical entity with protean manifestations have limited the progress in this field.
The spectrum of allogeneic SCT has increased to include elderly patients and alternative stem cell sources. Advances in critical care, better understanding of infectious disease post SCT and the advent of reduced-intensity and nonmyeloablative conditioning regimens has decreased early mortality after SCT. Thus, the combination of these factors, over time, has lead to an increasing number of patients post SCT at risk for developing cGVHD. Thus it is important to revisit and reaccess cGVHD in the current milleau of SCT.
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- Chapter
- Information
- Chronic Graft Versus Host DiseaseInterdisciplinary Management, pp. 87 - 100Publisher: Cambridge University PressPrint publication year: 2009
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