Hematology, Transfusion and Cell Therapy, cilt.47, sa.4, ss.1-2, 2025 (ESCI, Scopus)
Graft‐versus‐host disease (GvHD) is an important complication that can be observed after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The incidence of Acute GvHD (aGvHD) is around 30%-50% in HLA fully matched allo-HSCT. aGvHD is also common in haploidentical and matched unrelated donor transplantation.
The mechanism underlying tissue damage in aGvHD is massive inflammatory cytokine secretion. Proinflammatory cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6] are seen, as well as the increased expression of the receptor repertoire (pattern recognition receptors) on antigen-presenting cells.
The most important risk factor for GvHD is HLA mismatch. Other risk factors include sex disparity between donor and recipient, the intensity of the conditioning regimen, increased age, multiparous female donors, ineffective GvHD prophylaxis, and the source of the graft. A study showed that aGvHD was significantly more common with total body irradiation involving a myeloablative regimen and peripheral stem cell transplantation from a fully matched related donor.
