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June 1987

Syngeneic Graft-vs-Host Disease

Author Affiliations

Division of Hematology/Oncology The Children's Hospital and Dana Farber Institute 44 Binney St Boston, MA 02115

Arch Dermatol. 1987;123(6):741-742. doi:10.1001/archderm.1987.01660300063012

Graft-vs-hostD) can be a lethal complication of bone marrow transplantation. The acute form of the disease most often occurs by day 60 after transplant and may affect any or all of three major target organs, namely, skin, liver, and gastrointestinal ointestinal tract.1 y ute GVHD terized by a dermatitis that begins as a pruritic macular exanthem on the palms and soles. It may spread to the trunk and extremities and then progress to a generalized erythroderma with bullae formation and exfoliation. Hepatitis and enteritis often accompany extensive cutaneous lesions. Liver involvement is indicated by increases in bilirubin and alkaline phosphatase levels (often with only mildly elevated transaminase levels), with cholestasis, bile duct necrosis, and portal triaditis found on biopsy.2 Malabsorption and diarrhea characterize the gastrointestinal lesion, which may progress to hemorrhage and ileus. Gut histology reveals basal cell necrosis of the crypt, abscess formation, and epithelial denudation, with