| Skin Diseases Similar to Scleroderma (Main Menu) |
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| Graft-versus-Host Disease (GVHD) |
| This page was written by Shelley Ensz and has not yet been medically edited. See disclaimer. |
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| Overview of Graft-versus-Host Disease (GVHD) |
| Graft-versus-Host Disease (GVHD) is an autoimmune response to foreign cells, such as from skin grafting, bone marrow transplants, stem cell transplants, blood transfusions, or organ transplants. |
| What is GVHD? When you receive a donor's stem cells (the “graft”), their job is to recreate the donor's immune system in your body (the “host”). Graft versus host disease (GVHD) is the term used when this new immune system attacks your body. Your donor's cells see your body as “foreign” and attack it––causing damage. GVHD most commonly affects the skin, liver, and gastrointestinal tract. National Institutes of Health (NIH). |
| Lichen sclerosus and eosinophilic fasciitis as manifestations of chronic graft-versus-host disease: expanding the sclerodermoid spectrum. We describe 6 patients, all of whom developed LS and two of whom also developed EF in the context of chronic GVHD. Although all patients eventually developed morpheaform and/or sclerodermoid GVHD, LS was a prominent part of the initial presentation of chronic cutaneous GVHD in every case. PubMed. J Am Acad Dermatol. 2005 Oct;53(4):591-601. (Also see: Lichen Sclerosus and Eosinophilic Fasciitis) |
| Sclerodermatous Chronic Graft-Versus-Host Disease. The presence of lichen sclerosus, morphea, septal fibrosis, and fasciitis suggests that the sclerosis can start at and affect any level of the skin. Most patients have a good prognosis with treatment with prednisone and systemic immunosuppression. M. Matias De La Mano. AB0117 EULAR 2004. |
| Causes of Graft-versus-Host Disease (GVHD) |
| Autoimmune-like disease post-bone marrow transplantation. Chronic graft-vs-host disease is the major complication after bone marrow transplantation and mimics some autoimmune diseases, such as scleroderma, sicca syndrome, primary biliary cirrhosis and an increased prevalence of various autoantibodies. PubMed. Rev Med Interne. 2004 Jul;25(7):514-523. (Also see: Stell Cell Transplants) |
| Impaired thymic negative selection causes autoimmune graft-versus-host disease. These results demonstrate that impaired thymic negative selection can cause lethal autoimmune disease indistinguishable from acute GVHD in the context of a proinflammatory milieu when peripheral regulatory mechanisms are absent. PubMed. Blood 2003 Mar 27 |
| Diagnosis of Graft-versus-Host Disease (GVHD) |
| Cutaneous gene expression by DNA microarray in murine sclerodermatous graft-versus-host disease, a model for human scleroderma. These constellations of immunologic changes provide a "fingerprint" for fibrosing autoimmune disease. They are useful to understand the pathogenesis of Scl GVHD, to identify markers for early diagnosis of disease, and to devise more effective strategies for intervention in early scleroderma and Scl GVHD. PubMed. J Invest Dermatol. 2007 Feb;127(2):281-92. (Also see: Skin Fibrosis) |
| A Pediatric Case of Sclerodermatous Chronic Graft-versus-Host Disease. In the future, clarification of the pathogenesis of chronic GVHD and establishment of therapy will be necessary. PubMed. Pediatr Dermatol. 2003 Jul-Aug;20(4):327-31. |
| Bullous scleroderma-like changes in chronic graft-versus-host disease. Chronic cutaneous GVHD is categorized according to the type of skin lesions into lichenoid and sclerodermoid variants, but bullous scleroderma-like changes are exceptional. PubMed. J Eur Acad Dermatol Venereol 2003 Mar;17(2):200-3. |
| Treatments for Graft-versus-Host Disease (GVHD) |
| Effect of Increased Pigmentation on the Antifibrotic Response of Human Skin to UV-A1 Phototherapy. Clinical responses of sclerotic skin to UV-A1 phototherapy were modest because of UV-A1–induced skin darkening, which is photoprotective and attenuates antifibrotic responses. Arch Dermatol. 2008;144(7):851-858. (Also see: Morphea) |
| New Treatments Fight Graft-versus.-Host-Disease (GVHD) In Bone Marrow Transplant Patients. Using anti-inflammatory proteins in combination with steroids has yielded a response rate of over two-thirds, twice the traditional rate of complete response. Medical News Today. 02/06/07. |
| Safety and potential efficacy of low-dose methotrexate for treatment of chronic graft-versus-host disease. Methotrexate (MTX) appears to be a well-tolerated, inexpensive and possibly steroid-sparing agent that is worthy of further evaluation in prospective trials for treatment of chronic GVHD. PubMed. Bone Marrow Transplant. 2005 Jun 20. |
| Medium dose long-wavelength ultraviolet A (UVA1) phototherapy for the treatment of acute and chronic graft-versus-host disease of the skin. UVA1 as an adjunct to systemic immunosuppressive treatment was found to be safe, and effective in 10 patients with chronic cutaneous (seven lichenoid and three sclerodermoid) graft-versus-host disease (GVHD) after stem cell transplantation. PubMed. Bone Marrow Transplant. 2005 Jan 24. |
| Chronic graft-versus-host-disease-like dermopathy in a child with CD4+ cell microchimerism. We report the case of an 11-year-old boy suffering from a severe progressive chronic skin disease with clinical features of progressive systemic scleroderma, systemic lupus erythematosus and dermatomyositis. A distinct improvement of erythemas and sclerosis could be achieved by means of low-dose UVA1 phototherapy which was applied with escalating single doses of 3-12 J/cm2 for 35 consecutive days. PubMed. Dermatology. 2005;210(1):68-71. |
| Mechanism of action of extracorporeal photochemotherapy (ECP) in chronic graft-versus-host disease. ECP, considered as an effective treatment for patients with erythrodermic cutaneous T-cell lymphoma, has recently been used successfully in the treatment of GvHD. Only a better and more complete understanding of the various mechanisms involved will enable this new therapy to be made more effective and selective. PubMed. Br J Dermatol. 2004 Jun;150(6):1055-60. |
| Patient Stories for Graft-versus-Host Disease (GVHD) |
| Blog: Jackie Sue We Love You. Jackie has GVHD. THe blog covers her progress after her mini-allo MUD transplant. Her transplant was the first one to be performed by the Mayo Clinic. Bruce and Jackie. |
| Klaas: Scleroderma Graft-vs-Host Disease (GVHD) So I would like to know if, and when, I will be able to walk again... |
| (Spanish/Español) Klaas: Sclerodermia da GVHD Essiste un modo per capire se ci sono delle speranze e quali sono... |
| (Italiano) Fabiola: Paziente Affetta da Sclerodermia Morphea Dopo 5 anni si e' svegliata una sclero conseguenza pero' della GVHD (Graft Versus Host Disease) che viene dopo il trapianto di midollo... |
| Research for Graft-versus-Host Disease (GVHD) |
| Stem Cell Finding Could Help Reduce Transplant Rejection. A new study involving a type of stem cells from the lungs of transplant patients demonstrates for the first time that these progenitor cells reside in adult organs and are not derived from bone marrow, which leads to the possibility that the cells may be able to help with the rejection of donated organs. Newswise. University of Michigan Health System. 03/08/07. (Also see: Pulmonary Fibrosis ) |
| New Treatments Fight Graft-versus.-Host-Disease (GVHD) In Bone Marrow Transplant Patients. Using anti-inflammatory proteins in combination with steroids has yielded a response rate of over two-thirds, twice the traditional rate of complete response. Medical News Today. 02/06/07. |
| Emergent autoimmunity in graft versus host disease. These results indicate that donor T cell-mediated pathological damage during GVHD becomes donor APC (antigen presenting cells)-dependent, and provide a mechanistic explanation for the longstanding observation that GVHD is associated with autoimmune clinical manifestations. PubMed. Blood. 2005 Mar 3. |
