61. Improved Management Of Graft-Versus-Host-Disease -- GVHD The development of new drug treatments combined with advances in understanding the underlying mechanisms of graftversus-host disease (GVHD) have resulted http://www.marrow.org/PHYSICIAN/improved_management_gvhd.html

HOME CONTACT US CAREERS MEDIA ... PHYSICIAN RESOURCES switchIt("physician" ,"main_nav_sel"); Home Physician Resources > Improved Management of Graft-Versus-Host Disease E-mail a Friend Print this Page Improved Management of Graft-Versus-Host Disease The development of new drugs to treat graft-versus-host disease (GVHD), combined with early detection and advances in understanding the underlying mechanisms of the disease, have resulted in significant reductions in the morbidity and mortality of this potential complication of allogeneic transplantation. As a result of these advances, the risk of grade II-IV acute GVHD after allogeneic related transplants has decreased from 45% in 1976 to under 30% in 2001. [1] Importantly, the majority of this decrease has been in the most severe manifestations (grades III-IV). By definition, GVHD is classified as acute if it occurs before day 100 post-transplant and chronic if it persists or develops beyond day 100. Successful strategies to treat each type of GVHD have been developed. Prevention of Acute GVHD Several successful strategies are used to reduce the risk of developing acute GVHD. These include:

62. Graft-Versus-Host Disease (GVHD) Information for patients about graftversus-host disease (GVHD) symptoms, prevention and treatment after a bone marrow or cord blood transplant (BMT). http://www.marrow.org/PATIENT/gvhd.html

HOME CONTACT US CAREERS MEDIA ... PHYSICIAN RESOURCES switchIt("patient" ,"main_nav_sel"); Home Patient Resources Planning for Life after Transplant Managing Long-Term Effects of Transplant > Graft-Versus-Host Disease E-mail a Friend Print this Page Graft-Versus-Host Disease Graft-versus-host disease (GVHD) is a common side effect of an allogeneic bone marrow or cord blood transplant (also called a BMT). An allogeneic transplant uses blood-forming cells donated by a family member, unrelated donor or cord blood unit. In GVHD, the immune cells from the donated marrow or cord blood (the graft) attack the body of the transplant patient (the host). GVHD can affect many different parts of the body. The skin, eyes, stomach and intestines are affected most often. GVHD can range from mild to life-threatening. On this page: Why Graft-Versus-Host Disease Occurs Preventing Graft-Versus-Host Disease Acute and Chronic Graft-Versus-Host Disease Treatment of GVHD ... Information for Your Doctor Why Graft-Versus-Host Disease Occurs GVHD occurs because some of your donor's immune cells (known as T cells) attack cells in your body. The immune system uses markers called HLA antigens to recognize which cells belong in your body and which do not. When it finds cells with HLA antigens it does not recognize, it attacks those cells. In GVHD, your donor's immune cells do not recognize the HLA antigens on your body's cells, so they attack your cells. That is one reason your donor's HLA antigens need to match yours as closely as possible. Selecting a closely matched donor or cord blood unit can help reduce your risk of getting GVHD. (For more information, see

63. EMedicine - Graft Versus Host Disease : Article By Melanie K Kuechle, MD graft Versus host disease graft versus host disease (GVHD) occurs when immunologically competent cells are introduced into an immunoincompetent host. http://www.emedicine.com/derm/topic478.htm

(advertisement) Home Specialties Resource Centers CME ... Patient Education Articles Images CME Patient Education Advanced Search Consumer Health Link to this site Back to: eMedicine Specialties Dermatology Allergy And Immunology Graft Versus Host Disease Last Updated: January 4, 2005 Rate this Article Email to a Colleague Synonyms and related keywords: GVHD, graft-versus-host disease, allogenic hematopoietic cell transplantation, HCT, autologous hematopoietic cell transplantation, solid organ transplants, blood transfusions, maternal-fetal transfusions, graft-versus-leukemia reaction, graft versus leukemia reaction, peripheral blood stem cells, PBSCs, cord blood stem cells, CBSCs AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Clinical Differentials ... Bibliography Author: Melanie K Kuechle, MD , Assistant Professor, Department of Medicine, Division of Dermatology, University of Washington School of Medicine Melanie K Kuechle, MD, is a member of the following medical societies: Alpha Omega Alpha American Academy of Dermatology Society for Investigative Dermatology , and Washington State Medical Association Editor(s): Evan Farmer, MD

64. EMedicine - Graft Versus Host Disease : Article By Romeo A Mandanas, MD, FACP graft Versus host disease Barnes and Loutit first described (in mice) what is now known as graft versus host disease (GVHD) as a syndrome called secondary http://www.emedicine.com/med/topic926.htm

(advertisement) Home Specialties Resource Centers CME ... Patient Education Articles Images CME Patient Education Advanced Search Consumer Health Link to this site Back to: eMedicine Specialties Medicine, Ob/Gyn, Psychiatry, and Surgery Transplantation Graft Versus Host Disease Last Updated: March 29, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: GVHD, GVH disease, dermatitis, hepatitis, enteritis, allogeneic hematopoietic cell transplantation, HCT, marrow aplasia, acute GVHD, chronic GVHD AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Clinical Differentials ... Bibliography Author: Romeo A Mandanas, MD, FACP , Director of Transplant Services, Cancer Care Associates; Clinical Assistant Professor, Department of Internal Medicine, Section of Hematology/Oncology, University of Oklahoma Health Sciences Center Romeo A Mandanas, MD, FACP, is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine American Medical Association American Society for Blood and Marrow Transplantation American Society of Clinical Oncology , and American Society of Hematology Editor(s): Antoni Ribas, MD

65. ACOR Leukemia Links: Graft Versus Host Disease Links o How I treat chronic graftversus-host disease, by Georgia B. Vogelsang, o graft-Versus-host disease in Children Who Have Received a Cord-Blood or Bone http://leukemia.acor.org/gvhd.html

Search ACOR Site Contents: Types of Leukemia Living with Leukemia Transplants Survivor Stories Internet Support E-mail Lists Cancer Centers Graft Versus Host Disease (GVHD) General information on GVHD Journal Articles on GVHD Graft Versus Host Disease by Melanie K Kuechle, MD, from the eMedicine World Medicine Library . This is a very technical review of the diagnosis, and treatment of GVHD, includes an overview of the symptoms, and treatment for acute and chronic GVHD. Transplantation Biology, GvHD , a description of Research Projects for 1998-1999 from the Department of Microbiology and Immunology of the University of Miami School of Medicine Control of Graft versus host disease , from Frontiers in Bioscience Graft-versus-Host-Disease Web Site provides information on Graft-versus-Host Disease in English and en Francais. Le Site GVH en Francais How I treat chronic graft-versus-host disease , by Georgia B. Vogelsang, from Blood , March 1, 2001, Vol. 97, No. 5, pages 1196-1201. This article reviews the pathophysiology, risk factors, clinical manifestations, evaluation, treatment, and supportive care of chronic GVHD.

66. IBMT: FAQ - Graft-Versus-Host Disease This is the transplant against the patient , or graftversus-host reaction. The complications is called graft-versus-host disease (GvHD). http://www.ibmtindy.com/faq/graft.htm

Graft-Versus-Host Disease What Is Graft-Versus-Host Disease? A "reversed rejection" can also occur. Under this scenario, the healthy donor stem cells recognize the patient's tissues as foreign and attack them. This is the "transplant against the patient", or "Graft-versus-Host" reaction. The complications is called "Graft-versus-Host Disease" (GvHD). What Types Of GvHD Exist? Commonly, GvHD is divided into acute GvHD and chronic What Are The Symptoms Of Acute GvHD? The third tissue involved by acute GvHD is the liver. Patients develop jaundice, because the bile ducts become clogged and bile backs up into the blood instead of being excreted into the bowel. The jaundice is itself not life-threatening, but the liver can be damaged by the GvHD reaction. Other tissues, such as lung, adrenal glands, and pancreas can also show signs of acute GvHD, but their significance is uncertain. How Do You Grade GvHD?

67. Graft Versus Host Disease. DermNet NZ Authoritative facts about the skin from the New Zealand Dermatological Society. http://dermnetnz.org/systemic/gvhd.html

@import url("/common/screen.css"); DermNet NZ Ad Authoritative facts about the skin from the New Zealand Dermatological Society Incorporated Home For patients For doctors ... Site map Search: Home Systemic Graft versus host disease Graft versus host disease (GVHD) is a condition where following transplantation the donor's immune cells in the transplant (graft) make antibodies against the patient's tissues (host) and attack vital organs. Organs most often affected include the skin, gastrointestinal (GI) tract and the liver. Ninety percent of bone marrow transplants lead to GVHD. Solid organ transplantation, blood transfusions, and maternal-fetal transfusions have also been reported to cause GVHD less frequently. Types of GVHD There are two forms of GVHD. Acute GVHD Early form of GVHD that occurs within the first 3 months of transplantation First sign is usually a skin rash appearing on the hands, feet and face Gastrointestinal and liver dysfunction symptoms may follow Chronic GVHD Late form of GVHD that develops 3 months post transplantation Usually evolves from acute GVHD but occurs de novo in 20-30% of patients Cutaneous (skin) reactions resemble those of autoimmune disorders such as lupus lichen planus and especially systemic sclerosis What are the signs and symptoms?

68. Dr. Koop - Graft-versus-host Disease graftversus-host disease occurs when the new donor marrow makes antibodies Varying degrees of graft-versus-host disease are viewed as an expected http://drkoop.com/ency/93/001309.html

Home Health Reference Graft-versus-host disease Jul 29, 2005 Search: Dr.Koop MEDLINE Diseases Symptoms Procedures Natural Medicine ... Drug Library Inside DrKoop News Archive Animations Health Videos Health Tools ... Newsletters Graft-versus-host disease Injury Disease Nutrition Poison ... Prevention Graft-versus-host disease Definition: Graft-versus-host-disease is a condition that can occur following bone marrow transplant . The donor's immune cells in the transplanted marrow make antibodies against the host's (transplant patient's) tissues and attack the patient's vital organs. The condition may be acute or chronic, mild or severe. Severe cases can often be life-threatening. See also transplant rejection Alternative Names: GVHD Causes, incidence, and risk factors: Bone marrow transplants are performed in specialized hospitals to treat and potentially cure certain types of leukemia or other cancers that have invaded the bone marrow. Doctors also perform experimental bone marrow transplants to treat non-malignant conditions, such as sickle cell anemia. In the transplant, the host's bone marrow is destroyed with chemotherapy and/or radiation, and then the host receives replacement bone marrow from a donor. Most recipients undergo allogeneic transplants, which means they receive genetically matched bone marrow from a donor, usually a close family member or occasionally someone outside the family who has been found to be a match.

69. Introduction: Graft-versus-host Disease - WrongDiagnosis.com Introduction to graftversus-host disease as a medical condition including symptoms, diagnosis, misdiagnosis, treatment, prevention, and prognosis. http://www.wrongdiagnosis.com/g/graft_versus_host_disease/intro.htm

Home Symptoms Diseases Risks ... Diseases Search our medical database Subscribe to our free Newsletter sample Send this page to a friend Condition Lists By Organ By Symptom By Class By Prevalence ... List A-Z Current chapter: Graft-versus-host disease Next sections Basic Summary for Graft-versus-host disease Misdiagnosis of Graft-versus-host disease Articles about Graft-versus-host disease Glossary for Graft-versus-host disease Next chapters: Human adjuvant disease Mycosis fungoides Sclerodactyly Telangiectasia ... Feedback Introduction: Graft-versus-host disease Graft-versus-host disease: In most transplants, the patient's body may attempt to reject the transplanted organ ( transplant rejection ). However, in GVHD, the reverse happens; immune cells from the transplant attack the patient's cells. Graft-versus-host disease: A major complication of bone marrow transplantations and sometimes blood transfusions in which white blood cells, called lymphocytes, in the marrow or blood attack tissues in the body into which they were transplanted. Misdiagnosis and Graft-versus-host disease: Research more detailed information about misdiagnosis of Graft-versus-host disease , or research misdiagnosis of other diseases Contents for Graft-versus-host disease: Basic Summary for Graft-versus-host disease Misdiagnosis of Graft-versus-host disease Articles about Graft-versus-host disease Glossary for Graft-versus-host disease Footnotes: 1. excerpt from

70. AllRefer Health - Graft-Versus-Host Disease (GVHD) graftVersus-host disease (GVHD) information center covers causes, prevention, symptoms, diagnosis, treatment, incidence, risk factors, signs, tests, http://health.allrefer.com/health/graft-versus-host-disease-info.html

AllRefer Channels :: Yellow Pages Reference Health Home ... Contact Us Quick Jump ADD/ADHD Allergies Alzheimer's Disease Arthritis Asthma Back Pain Breast Cancer Cancer Colon Cancer Depression Diabetes Gallbladder Disease Heart Attack Hepatitis High Cholesterol HIV/AIDS Hypertension Lung Cancer Menopause Migraines/Headaches Osteoporosis Pneumonia Prostate Cancer SARS Stroke Urinary Tract Infection 1600+ More Conditions Alternative Medicine Health News Symptoms Guide Special Topics ... Medical Encyclopedia Web health.allrefer.com You are here : AllRefer.com Health Graft-Versus-Host Disease Graft-Versus-Host Disease Definition Prevention Treatment Expectations or Prognosis ... Go To Main Page Alternate Names : GVHD Definition Graft-versus-host-disease is a condition that can occur following bone marrow transplant . The donor's immune cells in the transplanted marrow make antibodies against the host's (transplant patient's) tissues and attack the patient's vital organs. The condition may be acute or chronic, mild or severe. Severe cases can often be life-threatening. See also transplant rejection Antibodies Bone marrow transplants are performed in specialized hospitals to treat and potentially cure certain types of leukemia or other cancers that have invaded the bone marrow. Doctors also perform experimental bone marrow transplants to treat non-malignant conditions, such as sickle cell anemia.

71. Accessing Article Schooneman F Claise C. Treatment of graft versus host disease by photopheresis? Transfus Sci 1996; 17 527536. PubMed ChemPort http://www.nature.com/bmt/journal/v35/n1s/full/1704851a.html

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72. What Is Graft-versus-host Disease? (if You Are Having A Transplant From A Donor) Stem cell and bone marrow transplants information about graftversus-host disease. http://www.cancerbacup.org.uk/Treatments/Stemcellbonemarrowtransplants/Generalin

@import "/stylesheet-site.css"; Search What is graft-versus-host disease? (if you are having a transplant from a donor) When a transplant is done using stem cells or bone marrow from a donor, even a brother or sister, there is a possibility that the new cells (the graft) will react against your tissues (the host). This reaction is called graft-versus-host disease (GVHD) Graft-versus-host disease is usually mild, since you will be prescribed drugs to prevent it happening. However, in some people it can become very severe and even life-threatening. It can cause diarrhoea, skin rashes and liver damage. The reaction can occur up to six months after your transplant. Graft-versus-host disease is more likely to affect you if you have a transplant at an older age and when the donor is unrelated or not the same match as you. A transplant from a donor who is not the same match is called a mismatched transplant Occasionally the donor’s bone marrow may be treated (purged) with antibodies to remove a type of white blood cell (T-lymphocyte) which is thought to cause the graft-versus-host disease. Removing the T-lymphocytes is most often done if a severe graft-versus-host reaction is possible – for example, if bone marrow from an unrelated donor is used. If graft-versus-host disease occurs, it does not mean that the transplant has failed. It may even be of benefit, as some of the cells involved in the reaction may also attack any cancer cells in the body that have survived the intensive treatment.

73. Cancer And Blood Diseases | Bone Marrow Transplant | Graft-Versus-Host Disease graftversus-host disease (GvHD) is a complication that may occur during the post-transplant period in children who receive marrow stem cells from relatives http://www.ucsfhealth.org/childrens/medical_services/cancer/bmt/gvhd.html

University of California, San Francisco About UCSF Search Welcome Hospitals and Clinics Appointments Billing ... Other Resources Bone Marrow Transplant Print Format Graft-Versus-Host Disease Graft-versus-host disease (GvHD) is a complication that may occur during the post-transplant period in children who receive marrow stem cells from relatives including histocompatible (HLA) matched siblings and parents, as well as those who receive marrow from unrelated donors GvHD reactions can occur when cells of the donor's immune system, called T lymphocytes, are infused via a blood or platelet transfusion or a bone marrow transplant into the recipient, who has received conditioning therapy . Blood and platelets are irradiated to prevent GvHD, but the donor graft cannot be treated this way since irradiation also would kill the normal bone marrow stem cells. Types and Manifestations GvHD can take two forms, acute and chronic: Acute GvHD usually develops within three months of the transplant and occurs in 20 percent to 25 percent of HLA-matched sibling transplants in children and 30 percent to 35 percent in adults. Acute GvHD is more common in patients undergoing unrelated transplants, in particular if there is an HLA-mismatch. Chronic GvHD usually develops three to 18 months after the transplant and occurs in approximately 30 percent of HLA matched sibling transplants.

74. Immunopathology The graft versus host disease here is marked by yellowbrown collections of bile in the canaliculi, as well as chronic inflammatory cells within the liver http://www-medlib.med.utah.edu/WebPath/IMMHTML/IMM034.html

The graft versus host disease (GVHD) here is affecting the liver, and marked by yellow-brown collections of bile within the canaliculi, as well as chronic inflammatory cells within the liver parenchyma.

75. Immunopathology Microscopically, graft versus host disease is one of the best examples of a process called apoptosis or single cell necrosis. There is vacuolization and http://www-medlib.med.utah.edu/WebPath/IMMHTML/IMM032.html

Microscopically, graft versus host disease (GVHD) is one of the best examples of a process called "apoptosis" or single cell necrosis. There is vacuolization and dissolution of epidermal cells along the basal layer, along with lymphocytes. At the arrow is a rounded pink apoptotic body.

76. Graft-versus-host Disease Definition - Medical Dictionary Definitions Of Popular Online Medical Dictionary and glossary with medical definitions. http://www.medterms.com/script/main/art.asp?articlekey=3628

77. Drug Blocks Graft Versus Host Disease In Mismatched Bone Marrow Drug Blocks graft Versus host disease In Mismatched Bone Marrow Transplant NEEDHAM, MA June 3, 1999 Results from a clinical trial of Repligen Corp. http://www.pslgroup.com/dg/1026fa.htm

78. The Sidney Kimmel Comprehensive Cancer Center At Johns Hopkins graft versus host disease is really two different diseases. Acute graftversus-host disease usually occurs within the first three months following a http://www.hopkinskimmelcancercenter.org/kpr/gvhdinformation.cfm

imgTag='GVHD More Information about GVHD Graft versus host disease is really two different diseases. An early form of Graft-versus-Host disease is called acute Graft-versus-Host disease. It occurs immediately after the transplant when the white cells rise. A late form of Graft-versus-Host disease also occurs. This is called chronic Graft-versus-Host disease. The signs and symptoms of these two diseases differ and they will be discussed separately. Graft-versus-Host disease is caused by the T-lymphocyte (or T cell), a type of white cell, recognizing the patient as being foreign. The T-cells are harvested with the bone marrow graft from the donor and transferred in the graft. T-cells normally help protect the body from infections. When a T-cell from the donor realizes it is in a new body it can attack the new body (the patient) as being foreign, based on a set of genetic markers or cells called human leukocyte antigens (HLA). We know that there are many minor markers that differ between donors and patients except when the patient and donor are identical twins. Before a transplant, extensive typing of the donor and recipient take place to try to make sure, as best we can, that donor and recipient are very closely matched. Chronic Graft-versus-Host disease is the late form of Graft-versus-Host disease and usually is seen two to three months after the transplant. The symptoms of chronic Graft-versus-Host disease resemble many spontaneously occurring auto immune disorders, such as lupus or scleroderma. Most patients with chronic Graft-versus-Host disease develop skin and mouth problems. Initially patients develop a dry, itchy rash which is raised. Many patients describe this pebbly rash as like alligator skin. If the Graft-versus-Host disease persists, the skin may become thickened. Areas of increased and decreased skin color may occur. There also may be hair loss, decrease in sweating in the skin, and premature greying of the hair related to chronic Graft-versus-Host disease.

79. Control Of Graft Versus Host Disease Control of graft versus host disease. For many tumors derived from the hematopoietic system, allogeneic bone marrow transplant is the treatment of choice. http://www.bioscience.org/news/scientis/gvhd1.htm

FRONTIERS IN BIOSCIENCE; SCIENCE NEWS DIGEST FOR PHYSICIANS AND SCIENTISTS June 97 Control of Graft versus host disease et al, have developed a strategy to eliminate these cells in the body of the host when GVHD occurs. The Herpes Simplex Virus (HSV) has a suicide gene (thymidine kinase) susceptible to the drug, ganciclovir. These authors introduced this gene (HSV-TK) into the bone marrow lymphocytes prior to their administration to patients. The lymphocytes were also transfected with a truncated form of the nerve growth factor receptor expressed on the cell surface. This transfection allowed in vitro selection of the transduced cells. In vivo , such expression made it possible to detect and characterize the transduced cells by fluorescence-activated cell sorting. These cells survived in patients up to 12 months and in 5/12 patients exhibited anti-tumor activity. When the GVHD occurred, the disease could effectively be controlled by the administration of the ganciclovir. The drug led to the elminiation of the tranduced cells in the host. Such strategy is likely to increase the effectiveness and safety of the bone marrow transplant in patients who require allogeneic bone marrow transplant. REFERENCES: Bonini C, 1997

80. How I Treat Chronic Graft-versus-host Disease -- Vogelsang 97 (5): 1196 -- Blood Severe chronic graftversus-host disease is characterized by a preponderance of CD4+ graft-versus-host disease and outcome in HLA-identical sibling http://www.bloodjournal.org/cgi/content/abstract/97/5/1196

QUICK SEARCH: [advanced] Author: Keyword(s): Year: Vol: Page: This Article Full Text Full Text (PDF) Alert me when this article is cited ... Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal ... Rights and Permissions PubMed PubMed Citation Articles by Vogelsang, G. B. Related Collections Transplantation How I Treat Clinical Observations, Interventions, and Therapeutic Trials Blood, 1 March 2001, Vol. 97, No. 5, pp. 1196-1201 HOW I TREAT How I treat chronic graft-versus-host disease Georgia B. Vogelsang From the Oncology Center, Johns Hopkins University School of Medicine, Baltimore, MD. Allogeneic stem cell transplantation (SCT) is now a commonplace procedure. Clinicians who care for patients with hematologic malignancies and aplastic anemia are almost certain to follow up patients after SCT. This review is intended to help clinicians observe patients for probably the most important late complication of SCT, chronic graft-versus-host disease (GVHD). It reviews the

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