Acute Graft versus Host Disease (GVHD) of Gastrointestinal Tract
Clinical
- Acute vs. chronic GVHD: clinically 100 day cutoff
- Poor correlation between pathologic features and clinical definition of acute vs. chronic
- Acute GVHD
- Develops 2-6 weeks after allogeneic transplant
- Primary targets
- Skin 90%
- Liver 40-60%
- GI tract 30-50%
- Early recognition of GVHD and prompt intervention improves outcome
- Advanced GVHD easy to diagnose but mortality can be 50%
- Specific features of GI GVHD
- Nausea, vomiting
- Abdominal pain
- Diarrhea
- GI involvement in acute GVHD of utmost prognostic significance
- Usual causes of mortality
- Manifests at same time or shortly after cutaneous GVHD
