Graft-versus-host disease and the development of late complications

Graft-versus-host disease (GVHD) in both its acute and chronic forms is a severe complication after allogeneic marrow transplantation. GVHD is associated with structural and functional defects in many organs and tissues. Severe immunoincompetence may result in frequent, often severe and at times fatal infections caused by various organisms. Prolonged antibiotic prophylaxis, and possibly immunoglobulin administration are beneficial. Ocular complications, airway and pulmonary damage, and oral or dental problems may cause severe morbidity. Despite aggressive management, a proportion of patients will succumb to these complications. Severe skin disease and joint contractures are currently seen less frequently, mostly due to early treatment of the disease. Psychosocial rehabilitation of patients with chronic GVHD is a demanding and protracted challenge and should be approached by a multidisciplinary team.