Chronic graft-versus-host disease. Part I: Epidemiology, pathogenesis, and clinical manifestations

J Am Acad Dermatol. 2024 Jan;90(1):1-16. doi: 10.1016/j.jaad.2022.12.024. Epub 2022 Dec 23.

Abstract

Chronic graft-versus-host disease is a major complication of allogeneic hematopoietic cell transplantation and a leading cause of long-term morbidity, nonrelapse mortality, and impaired health-related quality of life. The skin is commonly affected and presents heterogeneously, making the role of dermatologists critical in both diagnosis and treatment. In addition, new clinical classification and grading schemes inform treatment algorithms, which now include 3 U.S. Food and Drug Administration-approved therapies, and evolving transplant techniques are changing disease epidemiology. Part I reviews the epidemiology, pathogenesis, clinical manifestations, and diagnosis of chronic graft-versus-host disease. Part II discusses disease grading and therapeutic management.

Keywords: graft-versus-host disease; medical dermatology; transplantation.

Publication types

  • Review

MeSH terms

  • Bronchiolitis Obliterans Syndrome*
  • Chronic Disease
  • Graft vs Host Disease* / diagnosis
  • Graft vs Host Disease* / epidemiology
  • Graft vs Host Disease* / etiology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Quality of Life
  • Skin / pathology