We assessed age, sex, pre-transplant diagnosis, conditioning regimen, GVHD prophylaxis, preceding aGVHD and/or lichenoid cGVHD, and clinical properties of sclerodermatous cGVHD.
History of aGVHD (> Grade II) was present in 17 patients (77%), with hepatic involvement in 2, gastrointestinal tract involvement in 2 and skin involvement in 13 patients.
There was no statistically significant difference between the extensiveness of sclerodermatous GVHD and presence of previous aGVHD (p=1.
In our study, 17 of the 22 patients (77%) developed secondary chronic cutaneous GVHD following acute cutaneous GVHD, and in 5 patients (23%), de novo chronic cutaneous GVHD occurred without previous aGVHD.
9) suggested that the early-onset lichenoid GVHD is a unique form of aGVHD.
In alloHCT recipients, aGVHD can present as an acute hepatitis with serum aminotransferase levels over 1000 IU/L during the tapering of the immunosuppressive therapy being utilized to enable successful engraftment [50,51].
Although a liver biopsy is usually not necessary to establish a diagnosis of aGVHD when the other clinical findings of aGVHD are present, it may be required to establish the diagnosis of isolated hepatic GVHD and to rule out the other etiologies for the observed liver abnormalities, such as acute viral hepatitis, SOS, drug toxicity or sepsis.
Treatment of aGVHD of the liver usually involves the addition of methylprednisolone (MP) at a dose of 2 mg/kg/day to the existing immunosuppressive regimen [3,6,50].
cGVHD can either follow or progress from aGVHD or develop de novo in 20% of the cases [2,3,6,50,54,55].
Identify the number of incident and prevalent aGVHD
and cGVHD cases.
The protocol's mandated stopping point for two cases of Grade IV aGVHD is intended as a standard type of safeguard for Phase I studies to allow us, along with the FDA and the sites, to assess the data.
In aGVHD, the transplanted immune cells recognize the tissue as not being from the recipient's body.