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Graft-vs.-Host Disease
Ethan A. Smith, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Abbreviations

          • Graft-vs.-host disease (GVHD)
        • Definitions

          • Disease of allogenic bone marrow transplant (BMT) or stem cell transplant (SCT) recipients
          • Donor T lymphocytes cause damage to epithelial cells lining recipient target organs (gut, liver, skin)
          • Donor bone marrow or stem cells = graft
          • Recipient = host

        IMAGING

        • General Features

          • Radiographic Findings

            • Fluoroscopic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Derlin T et al: Magnetic resonance enterography for assessment of intestinal graft-versus-host disease after allogeneic stem cell transplantation. Eur Radiol. 25(5):1229-37, 2015
                                            2. Bodet-Milin C et al: 18F-FDG PET/CT for the assessment of gastrointestinal GVHD: results of a pilot study. Bone Marrow Transplant. 49(1):131-7, 2014
                                            3. Budjan J et al: Assessment of acute intestinal graft versus host disease by abdominal magnetic resonance imaging at 3 Tesla. Eur Radiol. 24(8):1835-44, 2014
                                            4. Sauter AW et al: Imaging findings and therapy response monitoring in chronic sclerodermatous graft-versus-host disease: preliminary data of a simultaneous PET/MRI approach. Clin Nucl Med. 38(8):e309-17, 2013
                                            5. Mahgerefteh SY et al: Radiologic imaging and intervention for gastrointestinal and hepatic complications of hematopoietic stem cell transplantation. Radiology. 258(3):660-71, 2011
                                            6. Spira D et al: Diagnostic imaging in hematology. Gastrointestinal graft-versus-host disease due to donor lymphocyte administration for rising autologous chimerism. Am J Hematol. 86(1):69, 2011
                                            7. Ferrara JL et al: Graft-versus-host disease. Lancet. 373(9674):1550-61, 2009
                                            8. Shaw PH et al: Hematopoietic stem-cell transplantation using unrelated cord-blood versus matched sibling marrow in pediatric bone marrow failure syndrome: one center's experience. Pediatr Transplant. 3(4):315-21, 1999
                                            9. Donnelly LF et al: Acute graft-versus-host disease in children: abdominal CT findings. Radiology. 199(1):265-8, 1996
                                            10. Donnelly LF: CT imaging of immunocompromised children with acute abdominal symptoms. AJR Am J Roentgenol. 167(4):909-13, 1996
                                            11. Benya EC et al: Abdominal complications after bone marrow transplantation in children: sonographic and CT findings. AJR Am J Roentgenol. 161(5):1023-7, 1993
                                            12. Day DL et al: Abdominal complications in pediatric bone marrow transplant recipients. Radiographics. 13(5):1101-12, 1993
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Graft-vs.-host disease (GVHD)
                                                  • Definitions

                                                    • Disease of allogenic bone marrow transplant (BMT) or stem cell transplant (SCT) recipients
                                                    • Donor T lymphocytes cause damage to epithelial cells lining recipient target organs (gut, liver, skin)
                                                    • Donor bone marrow or stem cells = graft
                                                    • Recipient = host

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • Fluoroscopic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Derlin T et al: Magnetic resonance enterography for assessment of intestinal graft-versus-host disease after allogeneic stem cell transplantation. Eur Radiol. 25(5):1229-37, 2015
                                                                                      2. Bodet-Milin C et al: 18F-FDG PET/CT for the assessment of gastrointestinal GVHD: results of a pilot study. Bone Marrow Transplant. 49(1):131-7, 2014
                                                                                      3. Budjan J et al: Assessment of acute intestinal graft versus host disease by abdominal magnetic resonance imaging at 3 Tesla. Eur Radiol. 24(8):1835-44, 2014
                                                                                      4. Sauter AW et al: Imaging findings and therapy response monitoring in chronic sclerodermatous graft-versus-host disease: preliminary data of a simultaneous PET/MRI approach. Clin Nucl Med. 38(8):e309-17, 2013
                                                                                      5. Mahgerefteh SY et al: Radiologic imaging and intervention for gastrointestinal and hepatic complications of hematopoietic stem cell transplantation. Radiology. 258(3):660-71, 2011
                                                                                      6. Spira D et al: Diagnostic imaging in hematology. Gastrointestinal graft-versus-host disease due to donor lymphocyte administration for rising autologous chimerism. Am J Hematol. 86(1):69, 2011
                                                                                      7. Ferrara JL et al: Graft-versus-host disease. Lancet. 373(9674):1550-61, 2009
                                                                                      8. Shaw PH et al: Hematopoietic stem-cell transplantation using unrelated cord-blood versus matched sibling marrow in pediatric bone marrow failure syndrome: one center's experience. Pediatr Transplant. 3(4):315-21, 1999
                                                                                      9. Donnelly LF et al: Acute graft-versus-host disease in children: abdominal CT findings. Radiology. 199(1):265-8, 1996
                                                                                      10. Donnelly LF: CT imaging of immunocompromised children with acute abdominal symptoms. AJR Am J Roentgenol. 167(4):909-13, 1996
                                                                                      11. Benya EC et al: Abdominal complications after bone marrow transplantation in children: sonographic and CT findings. AJR Am J Roentgenol. 161(5):1023-7, 1993
                                                                                      12. Day DL et al: Abdominal complications in pediatric bone marrow transplant recipients. Radiographics. 13(5):1101-12, 1993