Clinical and Diagnostic Pathology of Graft-versus-Host Disease

While comprehensive descriptions of the various aspects of Graft-versus-Host Disease (GvHD) have already been published, to date there is no monograph on the clinical and diagnostic pathology of this life-threatening disease. This book fills this gap and serves as a reliable guide to the histomorphologic diagnosis of GvHD. It contains a concise description of: the clinical pathology of GvHD; the applicability and limits of immunohistologic methods in the diagnosis of this disease; an instructive guide to the histological diagnosis; and differential diagnostic problems and potential diagnostic pitfalls. Graft-versus-host Disease (GvHD) occurs primarily but not exclusively as a complication in the context of allogeneic bone marrow or peripheral blood stem cell transplantation (BMT or PBSCT), the treatment of choice for various life-threatening diseases. GvHD may affect skin, liver, gut, and other organs and sometimes runs a devastating or even lethal course. The diagnosis of GvHD is based on both clinical and histomorphological parameters. However, due to the widespread use of GvHD prophylaxis in patients undergoing allogeneic BMT or PBSCT, the number of histologically typical lesions has decreased, while the number of atypical, low-grade or masked lesions has increased. Therefore, an update of the clinical and diagnostic pathology of GvHD of skin, liver, gastrointestinal tract and other organs is required. In the present volume the histological features of GvHD lesions under today's conditions are described and illustrated in detail. Particular emphasis is placed on differential diagnostic problems and histodiagnostic pitfalls. Finally, the applicability and limits of immunohistological methods for the diagnosis of GvHD are shown.