Acute Graft versus Host Disease (GVHD) of Gastrointestinal Tract

Definition

Attack by engrafted hematopoietic cells and their progeny on host gastrointestinal tissues in first 100 days post-transplant

Increased crypt apoptosis
In higher grades, crypt destruction and mucosal necrosis
Grade I
- Single cell apoptosis of crypt epithelium
  - At least one per tissue fragment
Grade II
- Destruction of single crypts or glands
  - With apoptotic crypt abscesses
Grade III
- Focal mucosal necrosis with ulceration
Grade IV
- Diffuse mucosal necrosis with denudation
In grades III and IV, adjacent areas should show apoptosis or apoptotic crypt abscesses

Neeraja Kambham MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342