Clinical Update on Graft- Versus-Host Disease in Children

The last decade has yielded many significant advances in hematopoietic transplantation
techniques, immunomodulatory prophylaxis, and diagnostic and treatment approaches to
acute and chronic graft-versus-host disease (GVHD). Unfortunately, GVHD remains the
cardinal complication in allogeneic hematopoietic stem cell transplantation, with significant
associated rates of morbidity and mortality. In this review, we highlight the numerous
strides that have been made in making hematopoietic transplantation more successful and
provide an update on the clinical and histopathological features of both acute and chronic
GVHD in the pediatric population. It is critical for dermatologists to be aware of the
characteristic features of cutaneous acute and chronic GVHD and to remain up to date on
the evolving spectrum of these conditions. We discuss 5 cases with clinico-pathologic
correlation to illustrate the key concepts and principles underlying the diagnosis and
management of both acute and chronic GVHD.
Semin Cutan Med Surg 29:92-105 © 2010 Published by Elsevier Inc.

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