BMTCN Ch 5 - GVHD questions and answers graded A+ 2023/2024

BMTCN Ch 5 - GVHD overall incidence of GVH? - correct answer 20-80% mortality rates d/t GVH? matched sibling vs unrelated - correct answer 18 % matched ib 20% unrelated what is GVH? - correct answer T cells from the donor recognize the recipient's cells as foreign and attack how does classic acute GVH present - correct answer erythematous mac/pap rash nausea/vomiting/anorexia/profuse diarrhea/ileus cholestatic liver disease all within 100 days of transplant or DLI what is persistent/late onset acute GVH? - correct answer includes features of acute beyond 100 days without chronic criteria how does classic chronic GVH present - correct answer looks like autoimmune disease multiple organs including skin, eyes, oral, lung, GI, liver when are most chronic GVH diagnosed? - correct answer within first year with a median of four to six months 5-10% dx after 1st year what is overlap syndrome? - correct answer pt presents with both acute and chronic may treat the acute but chronic lingers how is hyperacute GVH diagnosed? - correct answer fever >38.3 on two occasions for more than 3 days prior to engraftment w/ no resolution w/ meds rapid skin rash b/f engraftment hepatic dysfunction esp alk phos and bili before engraftment mucoid/green diarrhea w/ >5 stools per day how to treat hyperacute GVH? - correct answer high dose steroids risk factors for GVH - correct answer degree of mismatch PBSC female donor w/ male recipient recipient and donor >40 TBI myeloablative conditioning high CD34 cell dose/undepleted T cells type of GVH ppx previously transfused donor unrelated donor requirements for GVH dx (3) - correct answer graft must contain immunocompetent cells histoincompat between donor and recipient recipient incapable of mounting an effective immunologic response Phase 1 of GVH - correct answer host tissues are damaged by prep regimen leak inflamm cytokines like TNF alpha and IL-1 cytokines upregulate major and minor histocompatibility antigens on the host tissue Phase 2 of GVH - correct answer donor T cells find the antigens on the damaged tissues donor cells may recognize as foreign