Häusermann Peter, Walter Roland B, Halter Jörg, Biedermann Barbara C, Tichelli André, Itin Peter, Gratwohl Alois
Department of Dermatology, University Hospital Basel, Basel, Switzerland.
Dermatology. 2008;216(4):287-304. doi: 10.1159/000113941. Epub 2008 Jan 29.
Graft-versus-host disease (GVHD) is defined by the aggregation of clinical and pathological manifestations in a recipient of allogeneic stem cells or bone marrow transplantation in which specific immunological as well as nonspecific phenomena lead to characteristic features. GVHD is one of the major complications after hematopoietic stem cell transplantations and responsible for posttherapeutic morbidity, mortality and decrease in quality of life of those patients. GVHD is critically induced and maintained by donor immunocompetent cells that particularly attack epithelia of fast proliferating tissues such as those from the liver, gastrointestinal tract and skin. On the basis of the time of presentation, cutaneous GVHD has been originally divided into an acute and chronic disease. The latter has traditionally been further subclassified into a more epithelial or lichenoid and a predominantly dermal or sclerodermoid form. With respect to the growing importance of this therapeutic procedure and increasing numbers of outpatients presenting with chronic GVHD, this article summarizes the updated knowledge on this disease focused for the dermatologist, and additionally it emphasizes the recent consensus documents on the various aspects of chronic GVHD of the National Institute of Health.
移植物抗宿主病（GVHD）是指同种异体干细胞或骨髓移植受者出现临床和病理表现的聚集，其中特异性免疫以及非特异性现象导致了特征性表现。GVHD是造血干细胞移植后的主要并发症之一，是这些患者治疗后发病、死亡及生活质量下降的原因。GVHD主要由供体免疫活性细胞诱发并维持，这些细胞特别攻击快速增殖组织的上皮，如肝脏、胃肠道和皮肤的上皮。根据出现的时间，皮肤GVHD最初分为急性和慢性疾病。后者传统上进一步细分为上皮或苔藓样为主型和真皮或硬皮病样为主型。鉴于这种治疗方法的重要性日益增加以及出现慢性GVHD的门诊患者数量不断增多，本文总结了针对皮肤科医生的关于该疾病的最新知识，此外还强调了美国国立卫生研究院关于慢性GVHD各方面的最新共识文件。
