Transfusion-associated graft-versus-host disease

Vox Sang. 2008 Aug;95(2):85-93. doi: 10.1111/j.1423-0410.2008.01073.x. Epub 2008 Jun 9.

Abstract

Transfusion-associated graft-versus-host disease (TA-GvHD) is a rare complication of transfusion of cellular blood components producing a graft-versus-host clinical picture with concomitant bone marrow aplasia. The disease is fulminant and rapidly fatal in the majority of patients. TA-GvHD is caused by transfused blood-derived, alloreactive T lymphocytes that attack host tissue, including bone marrow with resultant bone marrow failure. Human leucocyte antigen similarity between the transfused lymphocytes and the host, often in conjunction with host immunosuppression, allows tolerance of the grafted lymphocytes to survive the host immunological response. Any blood component containing viable T lymphocytes can cause TA-GvHD, with fresher components more likely to have intact cells and, thus, able to cause disease. Treatment is generally not helpful, while prevention, usually via irradiation of blood components given to susceptible recipients, is the key to obviating TA-GvHD. Newer methods, such as pathogen inactivation, may play an important role in the future.

Publication types

  • Review

MeSH terms

  • Animals
  • Blood / radiation effects
  • Bone Marrow / immunology
  • Bone Marrow / pathology
  • Chick Embryo
  • Cytokines / metabolism
  • Diarrhea / etiology
  • Fever / etiology
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / etiology*
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / pathology
  • Graft vs Host Disease / prevention & control
  • Humans
  • Immunocompetence
  • Liver Diseases / etiology
  • Lymphocyte Depletion / methods
  • Lymphocyte Transfusion / adverse effects
  • Mice
  • Pancytopenia / etiology
  • Pancytopenia / immunology
  • Pancytopenia / prevention & control
  • T-Lymphocyte Subsets / immunology
  • T-Lymphocyte Subsets / metabolism
  • T-Lymphocyte Subsets / radiation effects
  • T-Lymphocyte Subsets / transplantation*
  • Transfusion Reaction*

Substances

  • Cytokines