Chronic graft-versus-host disease and its management in children

Abstract

Chronic graft-versus-host disease is sometimes a severe, disabling and long-lasting complication of allogeneic hematopoietic stem cell transplantation. Its frequency lies between 10 and 40% of pediatric graft recipients, depending on a number of risk factors. Such factors are the type, i.e. HLA-identical related or not, gender and age of the stem cell transplant donor, original diagnosis of the patient and, most importantly, the occurrence or not of a prior acute graft-verus-host disease. Chronic graft-versus-host disease manifests itself as a collagen vascular autoimmune disease. Its treatment consists of immuno-modulatory and antiinfections drugs, in addition to supportive care and psycho-social support. Medical treatment demands a tailor-made approach and careful and prolonged surveillance.