Skip to main content
SpringerLink
Log in

Graft Versus Host Disease

  • Reference work entry
  • First Online:
Albert and Jakobiec's Principles and Practice of Ophthalmology

  • 78 Accesses

Abstract

Graft versus host disease (GVHD) is a major complication of allogeneic blood and marrow transplantation (BMT) that remains as a common cause of morbidity and mortality after successful hematopoietic stem cell transplantation (HSCT) [1–5]. GVHD has been recognized since the early days of BMT, which was pioneered by Dr. Ed Thomas in the late 1950s [6] for which he received the Nobel Prize in Medicine. Unlike other forms of immunologic rejection in which the host reacts against the foreign cells of the graft, GVHD results from the reaction of transplanted immunocompetent cells against the host, hence its name graft (donor cells) vs. host (patient) disease. GVHD has long been recognized in animal systems, manifested by erythroderma, generalized wasting, diarrhea, jaundice, and ultimately death [7, 8].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 5,499.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 6,499.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Franklin RM, et al. Ocular manifestations of graft-vs-host disease. Ophthalmology. 1983;90(1):4–13.

    Article  CAS  PubMed  Google Scholar 

  2. Ferrara JL, Levine JE. Graft-versus-host disease in the 21st century: new perspectives on an old problem. Semin Hematol. 2006;43(1):1–2.

    Article  PubMed  Google Scholar 

  3. Ferrara JL, et al. Graft-versus-host disease. Lancet. 2009;373(9674):1550–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Lee SJ, et al. Severity of chronic graft-versus-host disease: association with treatment-related mortality and relapse. Blood. 2002;100(2):406–14.

    Article  CAS  PubMed  Google Scholar 

  5. Arai S, et al. Increasing incidence of chronic graft-versus-host disease in allogeneic transplantation: a report from the Center for International Blood and Marrow Transplant Research. Biol Blood Marrow Transplant. 2015;21(2):266–74.

    Article  PubMed  Google Scholar 

  6. Thomas ED, et al. Intravenous infusion of bone marrow in patients receiving radiation and chemotherapy. N Engl J Med. 1957;257(11):491–6.

    Article  CAS  PubMed  Google Scholar 

  7. Trentin JJ. Mortality and skin transplantability in x-irradiated mice receiving isologous, homologous or heterologous bone marrow. Proc Soc Exp Biol Med. 1956;92(4):688–93.

    Article  CAS  PubMed  Google Scholar 

  8. Deeg HJ, Antin JH. The clinical spectrum of acute graft-versus-host disease. Semin Hematol. 2006;43(1):24–31.

    Article  PubMed  Google Scholar 

  9. Armitage JO. Bone marrow transplantation. N Engl J Med. 1994;330(12):827–38.

    Article  CAS  PubMed  Google Scholar 

  10. Wagner JE Jr, Vogelsang GB, Beschorner WE. Pathogenesis and pathology of graft-vs.-host disease. Am J Pediatr Hematol Oncol. 1989;11(2):196–212.

    PubMed  Google Scholar 

  11. Weisdorf D, et al. Treatment of moderate/severe acute graft-versus-host disease after allogeneic bone marrow transplantation: an analysis of clinical risk features and outcome. Blood. 1990;75(4):1024–30.

    Article  CAS  PubMed  Google Scholar 

  12. Kollman C, et al. Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: the effect of donor age. Blood. 2001;98(7):2043–51.

    Article  CAS  PubMed  Google Scholar 

  13. Mielcarek M, et al. Graft-versus-host disease after nonmyeloablative versus conventional hematopoietic stem cell transplantation. Blood. 2003;102(2):756–62.

    Article  CAS  PubMed  Google Scholar 

  14. Mielcarek M, et al. Prognostic relevance of ‘early-onset’ graft-versus-host disease following non-myeloablative haematopoietic cell transplantation. Br J Haematol. 2005;129(3):381–91.

    Article  PubMed  Google Scholar 

  15. Jagasia M, et al. Risk factors for acute GVHD and survival after hematopoietic cell transplantation. Blood. 2012;119(1):296–307.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Zeiser R, Blazar BR. Acute graft-versus-host disease - biologic process, prevention, and therapy. N Engl J Med. 2017;377(22):2167–79.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Graze PR, Gale RP. Chronic graft versus host disease: a syndrome of disordered immunity. Am J Med. 1979;66(4):611–20.

    Article  CAS  PubMed  Google Scholar 

  18. Sullivan KM, et al. Chronic graft-versus-host disease in 52 patients: adverse natural course and successful treatment with combination immunosuppression. Blood. 1981;57(2):267–76.

    Article  CAS  PubMed  Google Scholar 

  19. Jack MK, et al. Ocular manifestations of graft-v-host disease. Arch Ophthalmol. 1983;101(7):1080–4.

    Article  CAS  PubMed  Google Scholar 

  20. Atkinson K, et al. Risk factors for chronic graft-versus-host disease after HLA-identical sibling bone marrow transplantation. Blood. 1990;75(12):2459–64.

    Article  CAS  PubMed  Google Scholar 

  21. Zeiser R, Blazar BR. Pathophysiology of chronic graft-versus-host disease and therapeutic targets. N Engl J Med. 2017;377(26):2565–79.

    Article  CAS  PubMed  Google Scholar 

  22. Ferrara JL, Deeg HJ. Graft-versus-host disease. N Engl J Med. 1991;324(10):667–74.

    Article  CAS  PubMed  Google Scholar 

  23. Ferrara JL, Reddy P. Pathophysiology of graft-versus-host disease. Semin Hematol. 2006;43(1):3–10.

    Article  CAS  PubMed  Google Scholar 

  24. Tseng LH, et al. Correlation between disparity for the minor histocompatibility antigen HA-1 and the development of acute graft-versus-host disease after allogeneic marrow transplantation. Blood. 1999;94(8):2911–4.

    Article  CAS  PubMed  Google Scholar 

  25. Ferrara JL, Levy R, Chao NJ. Pathophysiologic mechanisms of acute graft-vs.-host disease. Biol Blood Marrow Transplant. 1999;5(6):347–56.

    Article  CAS  PubMed  Google Scholar 

  26. Guinan EC, et al. Pivotal role of the B7:CD28 pathway in transplantation tolerance and tumor immunity. Blood. 1994;84(10):3261–82.

    Article  CAS  PubMed  Google Scholar 

  27. Ferrara JL. Cytokines other than growth factors in bone marrow transplantation. Curr Opin Oncol. 1994;6(2):127–34.

    Article  CAS  PubMed  Google Scholar 

  28. Cooke KR, et al. The biology of chronic graft-versus-host disease: a task force report from the National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2017;23(2):211–34.

    Article  PubMed  Google Scholar 

  29. Sale GE, et al. Abnormal CD4:CD8 ratios and delayed germinal center reconstitution in lymph nodes of human graft recipients with graft-versus-host disease (GVHD): an immunohistological study. Exp Hematol. 1992;20(8):1017–21.

    CAS  PubMed  Google Scholar 

  30. Jansen J, et al. Immunomagnetic CD4+ and CD8+ cell depletion for patients at high risk for severe acute GVHD. Bone Marrow Transplant. 1996;17(3):377–82.

    CAS  PubMed  Google Scholar 

  31. Matte-Martone C, et al. CD8+ but not CD4+ T cells require cognate interactions with target tissues to mediate GVHD across only minor H antigens, whereas both CD4+ and CD8+ T cells require direct leukemic contact to mediate GVL. Blood. 2008;111(7):3884–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Dutt S, et al. CD8+CD44(hi) but not CD4+CD44(hi) memory T cells mediate potent graft antilymphoma activity without GVHD. Blood. 2011;117(11):3230–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Sawamukai N, et al. Cell-autonomous role of TGFbeta and IL-2 receptors in CD4+ and CD8+ inducible regulatory T-cell generation during GVHD. Blood. 2012;119(23):5575–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Miyagawa F, et al. Identification of CD3+CD4-CD8- T cells as potential regulatory cells in an experimental murine model of graft-versus-host skin disease (GVHD). J Invest Dermatol. 2013;133(11):2538–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Thus KA, et al. The number of T cell Allo-epitopes associates with CD4+ and CD8+ T-cell infiltration in pediatric cutaneous GVHD. Cell Immunol. 2015;295(2):112–7.

    Article  CAS  PubMed  Google Scholar 

  36. Heinrichs J, et al. CD8(+) Tregs promote GVHD prevention and overcome the impaired GVL effect mediated by CD4(+) Tregs in mice. Onco Targets Ther. 2016;5(6):e1146842.

    Google Scholar 

  37. Keever CA, et al. Effect of GVHD on the recovery of NK cell activity and LAK precursors following BMT. Bone Marrow Transplant. 1993;12(3):289–95.

    CAS  PubMed  Google Scholar 

  38. Jiang YZ, et al. Interaction of natural killer cells with MHC class II: reversal of HLA-DR1-mediated protection of K562 transfectant from natural killer cell-mediated cytolysis by brefeldin-A. Immunology. 1996;87(3):481–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Reddy P, Ferrara JL. Immunobiology of acute graft-versus-host disease. Blood Rev. 2003;17(4):187–94.

    Article  PubMed  Google Scholar 

  40. Krenger W, Ferrara JL. Graft-versus-host disease and the Th1/Th2 paradigm. Immunol Res. 1996;15(1):50–73.

    Article  CAS  PubMed  Google Scholar 

  41. Krenger W, Ferrara JL. Dysregulation of cytokines during graft-versus-host disease. J Hematother. 1996;5(1):3–14.

    Article  CAS  PubMed  Google Scholar 

  42. Antin JH, Ferrara JL. Cytokine dysregulation and acute graft-versus-host disease. Blood. 1992;80(12):2964–8.

    Article  CAS  PubMed  Google Scholar 

  43. Ferrara JL. Cellular and cytokine effectors of acute graft versus host disease. Int J Hematol. 2002;76(Suppl 1):195–8.

    Article  PubMed  Google Scholar 

  44. Kumaki S, et al. Prolonged secretion of IL-15 in patients with severe forms of acute graft-versus-host disease after allogeneic bone marrow transplantation in children. Int J Hematol. 1998;67(3):307–12.

    Article  CAS  PubMed  Google Scholar 

  45. Scholl S, et al. Impact of early NK cell recovery on development of GvHD and CMV reactivation in dose-reduced regimen prior to allogeneic PBSCT. Bone Marrow Transplant. 2005;35(2):183–90.

    Article  CAS  PubMed  Google Scholar 

  46. Beelen DW, et al. Evidence that sustained growth suppression of intestinal anaerobic bacteria reduces the risk of acute graft-versus-host disease after sibling marrow transplantation. Blood. 1992;80(10):2668–76.

    Article  CAS  PubMed  Google Scholar 

  47. Porat R, et al. Enhancement of growth of virulent strains of Escherichia coli by interleukin-1. Science. 1991;254(5030):430–2.

    Article  CAS  PubMed  Google Scholar 

  48. Arend WP. Interleukin-1 receptor antagonist. Adv Immunol. 1993;54:167–227.

    Article  CAS  PubMed  Google Scholar 

  49. Abhyankar S, Gilliland DG, Ferrara JL. Interleukin-1 is a critical effector molecule during cytokine dysregulation in graft versus host disease to minor histocompatibility antigens. Transplantation. 1993;56(6):1518–23.

    Article  CAS  PubMed  Google Scholar 

  50. Schwaighofer H, et al. Endogenous interleukin 1 receptor antagonist during human bone marrow transplantation: increased levels during graft-versus-host disease, during infectious complications, and after immunoglobulin therapy. Transplantation. 1997;63(1):52–6.

    Article  CAS  PubMed  Google Scholar 

  51. Cullup H, et al. Donor interleukin 1 receptor antagonist genotype associated with acute graft-versus-host disease in human leucocyte antigen-matched sibling allogeneic transplants. Br J Haematol. 2001;113(3):807–13.

    Article  CAS  PubMed  Google Scholar 

  52. Ferrara JL, Abhyankar S, Gilliland DG. Cytokine storm of graft-versus-host disease: a critical effector role for interleukin-1. Transplant Proc. 1993;25(1 Pt 2):1216–7.

    CAS  PubMed  Google Scholar 

  53. Antin JH, et al. Recombinant human interleukin-1 receptor antagonist in the treatment of steroid-resistant graft-versus-host disease. Blood. 1994;84(4):1342–8.

    Article  CAS  PubMed  Google Scholar 

  54. Vallera DA, et al. Interleukin-1 or tumor necrosis factor-alpha antagonists do not inhibit graft-versus-host disease induced across the major histocompatibility barrier in mice. Transplantation. 1995;60(11):1371–4.

    CAS  PubMed  Google Scholar 

  55. Antin JH, et al. Interleukin-1 blockade does not prevent acute graft-versus-host disease: results of a randomized, double-blind, placebo-controlled trial of interleukin-1 receptor antagonist in allogeneic bone marrow transplantation. Blood. 2002;100(10):3479–82.

    Article  CAS  PubMed  Google Scholar 

  56. Kier P, et al. Autoantibodies in chronic GVHD: high prevalence of antinucleolar antibodies. Bone Marrow Transplant. 1990;6(2):93–6.

    CAS  PubMed  Google Scholar 

  57. Schultz KR, et al. Requirement for B cells in T cell priming to minor histocompatibility antigens and development of graft-versus-host disease. Bone Marrow Transplant. 1995;16(2):289–95.

    CAS  PubMed  Google Scholar 

  58. Zhang C, et al. Donor CD4+ T and B cells in transplants induce chronic graft-versus-host disease with autoimmune manifestations. Blood. 2006;107(7):2993–3001.

    Article  CAS  PubMed  Google Scholar 

  59. Zheng H, et al. Effector memory CD4+ T cells mediate graft-versus-leukemia without inducing graft-versus-host disease. Blood. 2008;111(4):2476–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Srinivasan M, et al. Donor B-cell alloantibody deposition and germinal center formation are required for the development of murine chronic GVHD and bronchiolitis obliterans. Blood. 2012;119(6):1570–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Young JS, et al. Donor B cells in transplants augment clonal expansion and survival of pathogenic CD4+ T cells that mediate autoimmune-like chronic graft-versus-host disease. J Immunol. 2012;189(1):222–33.

    Article  CAS  PubMed  Google Scholar 

  62. Sarantopoulos S, et al. High levels of B-cell activating factor in patients with active chronic graft-versus-host disease. Clin Cancer Res. 2007;13(20):6107–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Allen JL, et al. Increased BCR responsiveness in B cells from patients with chronic GVHD. Blood. 2014;123(13):2108–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Flynn R, et al. Targeting Syk-activated B cells in murine and human chronic graft-versus-host disease. Blood. 2015;125(26):4085–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Kheirkhah A, et al. A pilot randomized trial on safety and efficacy of a novel topical combined inhibitor of Janus kinase 1/3 and spleen tyrosine kinase for GVHD-associated ocular surface disease. Cornea. 2017;36(7):799–804.

    Article  PubMed  Google Scholar 

  66. Poe JC, et al. SYK inhibitor entospletinib prevents ocular and skin GVHD in mice. JCI Insight. 2018;3(19):e122430.

    Article  PubMed Central  Google Scholar 

  67. McManigle W, Youssef A, Sarantopoulos S. B cells in chronic graft-versus-host disease. Hum Immunol. 2019;80(6):393–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Zeiser R, Sarantopoulos S, Blazar BR. B-cell targeting in chronic graft-versus-host disease. Blood. 2018;131(13):1399–405.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Haseyama K, et al. Nephrotic syndrome related to chronic graft versus host disease after allogeneic bone marrow transplantation in a patient with malignant lymphoma. Rinsho Ketsueki. 1996;37(12):1383–8.

    CAS  PubMed  Google Scholar 

  70. Kemmner S, Verbeek M, Heemann U. Renal dysfunction following bone marrow transplantation. J Nephrol. 2017;30(2):201–9.

    Article  CAS  PubMed  Google Scholar 

  71. Przepiorka D, et al. 1994 consensus conference on acute GVHD grading. Bone Marrow Transplant. 1995;15(6):825–8.

    CAS  PubMed  Google Scholar 

  72. Filipovich AH, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant. 2005;11(12):945–56.

    Article  PubMed  Google Scholar 

  73. Shulman HM, et al. Histopathologic diagnosis of chronic graft-versus-host disease: National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: II. Pathology working group report. Biol Blood Marrow Transplant. 2006;12(1):31–47.

    Article  PubMed  Google Scholar 

  74. Schultz KR, et al. Toward biomarkers for chronic graft-versus-host disease: National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: III. Biomarker working group report. Biol Blood Marrow Transplant. 2006;12(2):126–37.

    Article  PubMed  Google Scholar 

  75. Couriel D, et al. Ancillary therapy and supportive care of chronic graft-versus-host disease: national institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: V. Ancillary therapy and supportive care working group report. Biol Blood Marrow Transplant. 2006;12(4):375–96.

    Article  PubMed  Google Scholar 

  76. Martin PJ, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: VI. Design of clinical trials working group report. Biol Blood Marrow Transplant. 2006;12(5):491–505.

    Article  PubMed  Google Scholar 

  77. Pavletic S, Vogelsang G. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: preface to the series. Biol Blood Marrow Transplant. 2005;11(12):943–4.

    Article  Google Scholar 

  78. Kim SK. Update on ocular graft versus host disease. Curr Opin Ophthalmol. 2006;17(4):344–8.

    Article  PubMed  Google Scholar 

  79. Jagasia MH, et al. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and staging working group report. Biol Blood Marrow Transplant. 2015;21(3):389–401.e1.

    Article  PubMed  Google Scholar 

  80. Chao NJ, Schlegel PG. Prevention and treatment of graft-versus-host disease. Ann N Y Acad Sci. 1995;770:130–40.

    Article  CAS  PubMed  Google Scholar 

  81. Strong Rodrigues K, et al. Cutaneous graft-versus-host disease: diagnosis and treatment. Am J Clin Dermatol. 2018;19(1):33–50.

    Article  PubMed  Google Scholar 

  82. Shulman HM, et al. Chronic cutaneous graft-versus-host disease in man. Am J Pathol. 1978;91(3):545–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  83. Villarreal CD, et al. Cutaneous graft-versus-host disease after hematopoietic stem cell transplant - a review. An Bras Dermatol. 2016;91(3):336–43.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Van Vloten WA, Scheffer E, Dooren LJ. Localized scleroderma-like lesions after bone marrow transplantation in man. A chronic graft versus host reaction. Br J Dermatol. 1977;96(4):337–41.

    Article  PubMed  Google Scholar 

  85. Lawley TJ, et al. Scleroderma, Sjogren-like syndrome, and chronic graft-versus-host disease. Ann Intern Med. 1977;87(6):707–9.

    Article  CAS  PubMed  Google Scholar 

  86. Hofmeister CC, et al. Graft-versus-host disease of the skin: life and death on the epidermal edge. Biol Blood Marrow Transplant. 2004;10(6):366–72.

    Article  PubMed  Google Scholar 

  87. Ramachandran V, Kolli SS, Strowd LC. Review of graft-versus-host disease. Dermatol Clin. 2019;37(4):569–82.

    Article  CAS  PubMed  Google Scholar 

  88. Totani A, et al. Vitiligo following stem-cell transplant. Bone Marrow Transplant. 2019;55:332.

    Article  PubMed  Google Scholar 

  89. Demetris AJ. Immune cholangitis: liver allograft rejection and graft-versus-host disease. Mayo Clin Proc. 1998;73(4):367–79.

    Article  CAS  PubMed  Google Scholar 

  90. Salomao M, et al. Histopathology of graft-vs-host disease of gastrointestinal tract and liver: an update. Am J Clin Pathol. 2016;145(5):591–603.

    Article  CAS  PubMed  Google Scholar 

  91. Couriel DR. Ancillary and supportive care in chronic graft-versus-host disease. Best Pract Res Clin Haematol. 2008;21(2):291–307.

    Article  PubMed  Google Scholar 

  92. Iqbal N, et al. Diagnosis of gastrointestinal graft-versus-host disease. Am J Gastroenterol. 2000;95(11):3034–8.

    Article  CAS  PubMed  Google Scholar 

  93. Malard F, Mohty M. New insight for the diagnosis of gastrointestinal acute graft-versus-host disease. Mediat Inflamm. 2014;2014:701013.

    Article  Google Scholar 

  94. Mathew NR, et al. Graft-versus-host disease of the CNS is mediated by TNF upregulation in microglia. J Clin Invest. 2019;130:1315.

    Article  Google Scholar 

  95. Hings IM, et al. Prednisone therapy for acute graft-versus-host disease: short- versus long-term treatment. A prospective randomized trial. Transplantation. 1993;56(3):577–80.

    Article  CAS  PubMed  Google Scholar 

  96. Lazarus HM, Rowe JM. New and experimental therapies for treating graft-versus-host disease. Blood Rev. 1995;9(2):117–33.

    Article  CAS  PubMed  Google Scholar 

  97. Couriel DR, et al. Extracorporeal photochemotherapy for the treatment of steroid-resistant chronic GVHD. Blood. 2006;107(8):3074–80.

    Article  CAS  PubMed  Google Scholar 

  98. Couriel DR, et al. Sirolimus in combination with tacrolimus and corticosteroids for the treatment of resistant chronic graft-versus-host disease. Br J Haematol. 2005;130(3):409–17.

    Article  CAS  PubMed  Google Scholar 

  99. Miklos D, et al. Ibrutinib for chronic graft-versus-host disease after failure of prior therapy. Blood. 2017;130(21):2243–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  100. Jaglowski SM, Blazar BR. How ibrutinib, a B-cell malignancy drug, became an FDA-approved second-line therapy for steroid-resistant chronic GVHD. Blood Adv. 2018;2(15):2012–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  101. Schutt SD, et al. Inhibition of BTK and ITK with Ibrutinib is effective in the prevention of chronic graft-versus-host disease in mice. PLoS One. 2015;10(9):e0137641.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  102. Waller EK, et al. Ibrutinib for chronic graft-versus-host disease after failure of prior therapy: 1-year update of a phase 1b/2 study. Biol Blood Marrow Transplant. 2019;25(10):2002–7.

    Article  CAS  PubMed  Google Scholar 

  103. Nunes NS, Kanakry CG. Mechanisms of graft-versus-host disease prevention by post-transplantation cyclophosphamide: an evolving understanding. Front Immunol. 2019;10:2668.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  104. Hunter AE, Bessell EM, Russell NH. Effective prevention of acute GVHD following allogeneic BMT with low leukaemic relapse using methotrexate and therapeutically monitored levels of cyclosporin a. Bone Marrow Transplant. 1992;10(5):431–4.

    PubMed  Google Scholar 

  105. von Bueltzingsloewen A, et al. Acute graft-versus-host disease prophylaxis with methotrexate and cyclosporine after busulfan and cyclophosphamide in patients with hematologic malignancies. Blood. 1993;81(3):849–55.

    Article  Google Scholar 

  106. Ringden O, et al. Decreased incidence of graft-versus-host disease and improved survival with methotrexate combined with cyclosporin compared with monotherapy in recipients of bone marrow from donors other than HLA identical siblings. Bone Marrow Transplant. 1992;9(1):19–25.

    CAS  PubMed  Google Scholar 

  107. Ringden O, et al. Methotrexate, cyclosporine, or both to prevent graft-versus-host disease after HLA-identical sibling bone marrow transplants for early leukemia? Blood. 1993;81(4):1094–101.

    Article  CAS  PubMed  Google Scholar 

  108. Hale G, Cobbold S, Waldmann H. T cell depletion with CAMPATH-1 in allogeneic bone marrow transplantation. Transplantation. 1988;45(4):753–9.

    Article  CAS  PubMed  Google Scholar 

  109. Hale G, Waldmann H. Control of graft-versus-host disease and graft rejection by T cell depletion of donor and recipient with Campath-1 antibodies. Results of matched sibling transplants for malignant diseases. Bone Marrow Transplant. 1994;13(5):597–611.

    CAS  PubMed  Google Scholar 

  110. Soiffer RJ, et al. Prevention of graft-versus-host disease by selective depletion of CD6-positive T lymphocytes from donor bone marrow. J Clin Oncol. 1992;10(7):1191–200.

    Article  CAS  PubMed  Google Scholar 

  111. Soiffer RJ, et al. Prediction of graft-versus-host disease by phenotypic analysis of early immune reconstitution after CD6-depleted allogeneic bone marrow transplantation. Blood. 1993;82(7):2216–23.

    Article  CAS  PubMed  Google Scholar 

  112. Belanger C, et al. Use of an anti-interleukin-2 receptor monoclonal antibody for GVHD prophylaxis in unrelated donor BMT. Bone Marrow Transplant. 1993;11(4):293–7.

    CAS  PubMed  Google Scholar 

  113. De Witte T, et al. Allogeneic bone marrow transplantation for leukemia with marrow grafts treated by counterflow centrifugation. Bone Marrow Transplant. 1993;12(Suppl 3):S2–6.

    PubMed  Google Scholar 

  114. Antin JH. Graft-versus-leukemia: no longer an epiphenomenon. Blood. 1993;82(8):2273–7.

    Article  CAS  PubMed  Google Scholar 

  115. Marmont AM, et al. T-cell depletion of HLA-identical transplants in leukemia. Blood. 1991;78(8):2120–30.

    Article  CAS  PubMed  Google Scholar 

  116. Cragg L, et al. A randomized trial comparing prednisone with antithymocyte globulin/prednisone as an initial systemic therapy for moderately severe acute graft-versus-host disease. Biol Blood Marrow Transplant. 2000;6(4A):441–7.

    Article  CAS  PubMed  Google Scholar 

  117. Wang Y, et al. Low-dose post-transplant cyclophosphamide and anti-thymocyte globulin as an effective strategy for GVHD prevention in haploidentical patients. J Hematol Oncol. 2019;12(1):88.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  118. Soltermann Y, et al. Reduced dose of post-transplantation cyclophosphamide compared to ATG for graft-versus-host disease prophylaxis in recipients of mismatched unrelated donor hematopoietic cell transplantation: a single-center study. Ann Hematol. 2019;98(6):1485–93.

    Article  CAS  PubMed  Google Scholar 

  119. Podichetty JT, et al. Pharmacokinetics of Basiliximab for the prevention of graft-versus-host disease in patients undergoing hematopoietic cell transplantation with minimal-intensity cyclophosphamide and Fludarabine. Pharmacotherapy. 2019;40:26.

    Article  CAS  PubMed  Google Scholar 

  120. Bolanos-Meade J, et al. Three prophylaxis regimens (tacrolimus, mycophenolate mofetil, and cyclophosphamide; tacrolimus, methotrexate, and bortezomib; or tacrolimus, methotrexate, and maraviroc) versus tacrolimus and methotrexate for prevention of graft-versus-host disease with haemopoietic cell transplantation with reduced-intensity conditioning: a randomised phase 2 trial with a non-randomised contemporaneous control group (BMT CTN 1203). Lancet Haematol. 2019;6(3):e132–43.

    Article  PubMed  PubMed Central  Google Scholar 

  121. Arocker-Mettinger E, et al. Manifestations of graft-versus-host disease following allogenic bone marrow transplantation. Eur J Ophthalmol. 1991;1(1):28–32.

    Article  CAS  PubMed  Google Scholar 

  122. Coskuncan NM, et al. The eye in bone marrow transplantation. VI. Retinal complications. Arch Ophthalmol. 1994;112(3):372–9.

    Article  CAS  PubMed  Google Scholar 

  123. Gloor B, et al. Multiple cotton wool spots following bone marrow transplantation for treatment of acute lymphatic leukaemia. Br J Ophthalmol. 1985;69(5):320–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  124. Bernauer W, et al. Microvasculopathy in the ocular fundus after bone marrow transplantation. Ann Intern Med. 1991;115(12):925–30.

    Article  CAS  PubMed  Google Scholar 

  125. Giannaccare G, et al. Ocular surface analysis in hematological patients before and after allogeneic hematopoietic stem cell transplantation: implication for daily clinical practice. Eye (Lond). 2017;31(10):1417–26.

    Article  CAS  Google Scholar 

  126. Ogawa Y, et al. Dry eye after haematopoietic stem cell transplantation. Br J Ophthalmol. 1999;83(10):1125–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  127. Inamoto Y, et al. Non-graft-versus-host disease ocular complications after hematopoietic cell transplantation: expert review from the late effects and quality of life working committee of the center for international blood and marrow transplant research and the transplant complications working party of the European Society for blood and marrow transplantation. Biol Blood Marrow Transplant. 2019;25(5):e145–54.

    Article  PubMed  Google Scholar 

  128. Kim RY, et al. Scleritis as the initial clinical manifestation of graft-versus-host disease after allogenic bone marrow transplantation. Am J Ophthalmol. 2002;133(6):843–5.

    Article  PubMed  Google Scholar 

  129. Robinson MR, et al. Topical corticosteroid therapy for cicatricial conjunctivitis associated with chronic graft-versus-host disease. Bone Marrow Transplant. 2004;33(10):1031–5.

    Article  CAS  PubMed  Google Scholar 

  130. Kim SK, et al. Superior limbic keratoconjunctivitis in chronic ocular graft vs. host disease. Invest Ophthalmol Vis Sci. 2005;46(Suppl):2661.

    Google Scholar 

  131. Ogawa Y, et al. Dry eye associated with chronic graft-versus-host disease. Adv Exp Med Biol. 2002;506(Pt B):1041–5.

    Article  CAS  PubMed  Google Scholar 

  132. Hirst LW, et al. The eye in bone marrow transplantation. I. Clinical study. Arch Ophthalmol. 1983;101(4):580–4.

    Article  CAS  PubMed  Google Scholar 

  133. Jack MK, Hicks JD. Ocular complications in high-dose chemoradiotherapy and marrow transplantation. Ann Ophthalmol. 1981;13(6):709–11.

    CAS  PubMed  Google Scholar 

  134. Inamoto Y, et al. Ocular graft-versus-host disease after hematopoietic cell transplantation: expert review from the late effects and quality of life working committee of the CIBMTR and transplant complications working party of the EBMT. Bone Marrow Transplant. 2019;54(5):662–73.

    Article  PubMed  Google Scholar 

  135. Filipovich AH. Diagnosis and manifestations of chronic graft-versus-host disease. Best Pract Res Clin Haematol. 2008;21(2):251–7.

    Article  CAS  PubMed  Google Scholar 

  136. Jabs DA, et al. The eye in bone marrow transplantation. III. Conjunctival graft-vs-host disease. Arch Ophthalmol. 1989;107(9):1343–8.

    Article  CAS  PubMed  Google Scholar 

  137. West RH, Szer J, Pedersen JS. Ocular surface and lacrimal disturbances in chronic graft-versus-host disease: the role of conjunctival biopsy. Aust N Z J Ophthalmol. 1991;19(3):187–91.

    Article  CAS  PubMed  Google Scholar 

  138. Janin A, et al. Pseudomembranous conjunctivitis following bone marrow transplantation: immunopathological and ultrastructural study of one case. Hum Pathol. 1996;27(3):307–9.

    Article  CAS  PubMed  Google Scholar 

  139. Kim SK. Ocular graft versus host disease. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea. St. Louis: Mosby; 2004. p. 879–85.

    Google Scholar 

  140. Yoshida A, et al. Apoptosis in perforated cornea of a patient with graft-versus-host disease. Can J Ophthalmol. 2006;41(4):472–5.

    Article  PubMed  Google Scholar 

  141. Kim SK, et al. Ocular graft vs. host disease experience from MD Anderson Cancer Center: newly described clinical specturm and new approach to the management of Stage III and IV ocular GVHD. Biol Blood Marrow Transplant. 2006;12(2(S1)):49.

    Article  Google Scholar 

  142. Uchino M, et al. Ocular complications in a child with acute graft-versus-host disease following cord blood stem cell transplantation: therapeutic challenges. Acta Ophthalmol Scand. 2006;84(4):545–8.

    Article  PubMed  Google Scholar 

  143. Janin-Mercier A, et al. Systemic evaluation of Sjogren-like syndrome after bone marrow transplantation in man. Transplantation. 1987;43(5):677–9.

    Article  CAS  PubMed  Google Scholar 

  144. Shulman HM, et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients. Am J Med. 1980;69(2):204–17.

    Article  CAS  PubMed  Google Scholar 

  145. Khanal S, Tomlinson A. Tear physiology in dry eye associated with chronic GVHD. Bone Marrow Transplant. 2012;47(1):115–9.

    Article  CAS  PubMed  Google Scholar 

  146. Kim S, et al. Changes of meibomian glands in the early stage of post hematopoietic stem cell transplantation. Exp Eye Res. 2017;163:85–90.

    Article  CAS  PubMed  Google Scholar 

  147. Que L, Zhang X, Li M. Single-center retrospective study on meibomian gland loss in patients with ocular chronic graft-versus-host disease. Eye Contact Lens. 2018;44(Suppl 2):S169–75.

    Article  PubMed  Google Scholar 

  148. Kheirkhah A, et al. Subtarsal fibrosis is associated with ocular surface epitheliopathy in graft-versus-host disease. Am J Ophthalmol. 2018;189:102–10.

    Article  PubMed  Google Scholar 

  149. Hwang HS, et al. Longitudinal analysis of meibomian gland dropout in patients with ocular graft-versus-host disease. Ocul Surf. 2019;17(3):464–9.

    Article  PubMed  Google Scholar 

  150. Tichelli A, et al. Late-onset keratoconjunctivitis sicca syndrome after bone marrow transplantation: incidence and risk factors. European group or blood and marrow transplantation (EBMT) working party on late effects. Bone Marrow Transplant. 1996;17(6):1105–11.

    CAS  PubMed  Google Scholar 

  151. Livesey SJ, Holmes JA, Whittaker JA. Ocular complications of bone marrow transplantation. Eye. 1989;3(Pt 3):271–6.

    Article  PubMed  Google Scholar 

  152. Calissendorff B, el Azazi M, Lonnqvist B. Dry eye syndrome in long-term follow-up of bone marrow transplanted patients. Bone Marrow Transplant. 1989;4(6):675–8.

    CAS  PubMed  Google Scholar 

  153. Mencucci R, et al. Ophthalmological aspects in allogenic bone marrow transplantation: Sjogren-like syndrome in graft-versus-host disease. Eur J Ophthalmol. 1997;7(1):13–8.

    Article  CAS  PubMed  Google Scholar 

  154. Ogawa Y, et al. International chronic ocular graft-vs-host-disease (GVHD) consensus group: proposed diagnostic criteria for chronic GVHD (part I). Sci Rep. 2013;3:3419.

    Article  PubMed  PubMed Central  Google Scholar 

  155. Amparo F, et al. Corneal fluorescein staining and ocular symptoms but not Schirmer test are useful as indicators of response to treatment in chronic ocular GVHD. Ocul Surf. 2018;16(3):377–81.

    Article  PubMed  Google Scholar 

  156. Jabs DA, et al. The eye in bone marrow transplantation. II. Histopathology. Arch Ophthalmol. 1983;101(4):585–90.

    Article  CAS  PubMed  Google Scholar 

  157. Gratwhol AA, et al. Sjogren-type syndrome after allogeneic bone-marrow transplantation. Ann Intern Med. 1977;87(6):703–6.

    Article  PubMed  Google Scholar 

  158. Sale GE, et al. Oral and ophthalmic pathology of graft versus host disease in man: predictive value of the lip biopsy. Hum Pathol. 1981;12(11):1022–30.

    Article  CAS  PubMed  Google Scholar 

  159. Ogawa Y, et al. A significant role of stromal fibroblasts in rapidly progressive dry eye in patients with chronic GVHD. Invest Ophthalmol Vis Sci. 2001;42(1):111–9.

    CAS  PubMed  Google Scholar 

  160. Ogawa Y, et al. Periductal area as the primary site for T-cell activation in lacrimal gland chronic graft-versus-host disease. Invest Ophthalmol Vis Sci. 2003;44(5):1888–96.

    Article  PubMed  Google Scholar 

  161. Rojas B, et al. Cell populations and adhesion molecules expression in conjunctiva before and after bone marrow transplantation. Exp Eye Res. 2005;81(3):313–25.

    Article  CAS  PubMed  Google Scholar 

  162. Aronni S, et al. Upregulation of ICAM-1 expression in the conjunctiva of patients with chronic graft-versus-host disease. Eur J Ophthalmol. 2006;16(1):17–23.

    Article  CAS  PubMed  Google Scholar 

  163. Hallberg D, et al. Conjunctival polyploid cells and donor-derived myofibroblasts in ocular GvHD. Bone Marrow Transplant. 2016;51(5):692–7.

    Article  CAS  PubMed  Google Scholar 

  164. Dunn JP, et al. Bone marrow transplantation and cataract development. Arch Ophthalmol. 1993;111(10):1367–73.

    Article  CAS  PubMed  Google Scholar 

  165. Calissendorff B, Bolme P, el Azazi M. The development of cataract in children as a late side-effect of bone marrow transplantation. Bone Marrow Transplant. 1991;7(6):427–9.

    CAS  PubMed  Google Scholar 

  166. Rapoport Y, et al. Validation of international chronic ocular graft-versus-host disease (GVHD) group diagnostic criteria as a chronic ocular GVHD-specific metric. Cornea. 2017;36(2):258–63.

    Article  PubMed  Google Scholar 

  167. Berchicci L, et al. Ocular chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation in an Italian referral center. Ocul Surf. 2018;16(3):314–21.

    Article  PubMed  Google Scholar 

  168. Schargus M, et al. Correlation between tear film osmolarity and the disease score of the international chronic ocular graft-versus-host-disease consensus group in hematopoietic stem cell transplantation patients. Cornea. 2015;34(8):911–6.

    Article  PubMed  Google Scholar 

  169. Ogawa Y. Sjogren’s syndrome, non-Sjogren’s syndrome, and graft-versus-host disease related dry eye. Invest Ophthalmol Vis Sci. 2018;59(14):DES71–9.

    Article  CAS  PubMed  Google Scholar 

  170. Giannaccare G, et al. Comparison among different diagnostic criteria for chronic ocular graft-versus-host disease applied with and without pre-transplant ophthalmological examination. Eye (Lond). 2019;33(1):154–60.

    Article  Google Scholar 

  171. Dignan FL, et al. Organ-specific management and supportive care in chronic graft-versus-host disease. Br J Haematol. 2012;158(1):62–78.

    Article  CAS  PubMed  Google Scholar 

  172. Shikari H, Antin JH, Dana R. Ocular graft-versus-host disease: a review. Surv Ophthalmol. 2013;58(3):233–51.

    Article  PubMed  Google Scholar 

  173. Kim S, et al. Early topical steroid treatment for grade IV acute ocular graft vs. host disease (GVHD) with corneal epitherlial sloughing. Invest Ophthalmol Vis Sci. 2003;44(Suppl):1387.

    Google Scholar 

  174. Ogawa Y, et al. Topical tranilast for treatment of the early stage of mild dry eye associated with chronic GVHD. Bone Marrow Transplant. 2010;45(3):565–9.

    Article  CAS  PubMed  Google Scholar 

  175. Yin J, et al. Reduced efficacy of low-dose topical steroids in dry eye disease associated with graft-versus-host disease. Am J Ophthalmol. 2018;190:17–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  176. Amparo F, et al. Topical interleukin 1 receptor antagonist for treatment of dry eye disease: a randomized clinical trial. JAMA Ophthalmol. 2013;131(6):715–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  177. Sanz-Marco E, et al. Treatment of refractory dry eye associated with graft versus host disease with 0.03% tacrolimus eyedrops. J Ocul Pharmacol Ther. 2013;29(8):776–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  178. Wang Y, et al. Ocular surface and tear functions after topical cyclosporine treatment in dry eye patients with chronic graft-versus-host disease. Bone Marrow Transplant. 2008;41(3):293–302.

    Article  CAS  PubMed  Google Scholar 

  179. Chhabra S, et al. Lifitegrast ophthalmic solution for treatment of ocular chronic graft-versus-host disease. Leuk Lymphoma. 2019;61:1–6.

    Google Scholar 

  180. Solomon A, et al. Doxycycline inhibition of interleukin-1 in the corneal epithelium. Invest Ophthalmol Vis Sci. 2000;41(9):2544–57.

    CAS  PubMed  Google Scholar 

  181. Inamoto Y, et al. Bandage soft contact lenses for ocular graft-versus-host disease. Biol Blood Marrow Transplant. 2015;21(11):2002–7.

    Article  PubMed  PubMed Central  Google Scholar 

  182. Lee SM, et al. Long-term effect of corneoscleral contact lenses on refractory ocular surface diseases. Cont Lens Anterior Eye. 2019;42(4):399–405.

    Article  PubMed  Google Scholar 

  183. DeLoss KS, et al. PROSE treatment for ocular chronic graft-versus-host disease as a clinical network expands. Eye Contact Lens. 2016;42(4):262–6.

    Article  PubMed  Google Scholar 

  184. Balaram M, Dana MR. Phacoemulsification in patients after allogeneic bone marrow transplantation. Ophthalmology. 2001;108(9):1682–7.

    Article  CAS  PubMed  Google Scholar 

  185. Pidala J, et al. Patient-reported quality of life is associated with severity of chronic graft-versus-host disease as measured by NIH criteria: report on baseline data from the chronic GVHD consortium. Blood. 2011;117(17):4651–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  186. Sun YC, et al. Impact of ocular chronic graft-versus-host disease on quality of life. Biol Blood Marrow Transplant. 2015;21(9):1687–91.

    Article  PubMed  PubMed Central  Google Scholar 

  187. Saboo US, et al. Vision-related quality of life in patients with ocular graft-versus-host disease. Ophthalmology. 2015;122(8):1669–74.

    Article  PubMed  Google Scholar 

  188. Pezzotta S, et al. A cross-sectional study on vision-related quality of life in patients with ocular GvHD. Bone Marrow Transplant. 2015;50(9):1224–6.

    Article  CAS  PubMed  Google Scholar 

  189. Sabti S, et al. Punctal occlusion is safe and efficient for the treatment of keratoconjunctivitis sicca in patients with ocular GvHD. Bone Marrow Transplant. 2012;47(7):981–4.

    Article  CAS  PubMed  Google Scholar 

  190. Yaguchi S, et al. Surgical management of lacrimal punctal cauterization in chronic GVHD-related dry eye with recurrent punctal plug extrusion. Bone Marrow Transplant. 2012;47(11):1465–9.

    Article  CAS  PubMed  Google Scholar 

  191. Mirza SN, et al. The amniotic membrane in acute stage IV ocular graft versus host disease; case report and review of the literature. Invest Ophthalmol Vis Sci. 2012;53(S14):1254.

    Google Scholar 

  192. Peric Z, et al. Amniotic membrane transplantation-a new approach to crossing the HLA barriers in the treatment of refractory ocular graft-versus-host disease. Bone Marrow Transplant. 2018;53(11):1466–9.

    Article  PubMed  Google Scholar 

  193. Holland EJ. Management of Limbal Stem Cell Deficiency: a historical perspective, past, present, and future. Cornea. 2015;34(Suppl 10):S9–15.

    Article  PubMed  Google Scholar 

  194. Greenan E, Vandenberghe E, Murphy CC. Refractory recurrent ocular graft versus host disease. BMJ Case Rep. 2019;12(12):e232579.

    Article  PubMed  PubMed Central  Google Scholar 

  195. Penn EA, Soong HK. Cataract surgery in allogeneic bone marrow transplant recipients with graft-versus-host disease(1). J Cataract Refract Surg. 2002;28(3):417–20.

    Article  PubMed  Google Scholar 

  196. de Melo Franco R, et al. Outcomes of cataract surgery in graft-versus-host disease. Cornea. 2015;34(5):506–11.

    Article  PubMed  Google Scholar 

  197. Saboo US, et al. Outcomes of phacoemulsification in patients with chronic ocular graft-versus-host disease. Graefes Arch Clin Exp Ophthalmol. 2015;253(6):901–7.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Harvard University, Boston, MA, USA

    Stella K. Kim

  2. UTHealth Medical School, The Robert Cizik Eye Clinic, Houston, TX, USA

    Stella K. Kim

  3. Retina Consultants of Texas, Houston, TX, USA

    Rosa Y. Kim

  4. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA

    M. Reza Dana

Authors
  1. Stella K. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rosa Y. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Reza Dana
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stella K. Kim .

Editor information

Editors and Affiliations

  1. Casey Eye Institute, Oregon Health & Science, Portland, OR, USA

    Daniel M. Albert

  2. Department of Ophthalmology, Massachusetts Eye and Ear, Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Joan W. Miller

  3. Department of Ophthalmology, University of Illinois College of Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Dimitri T. Azar

  4. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA

    Lucy H. Young

Section Editor information

  1. Penn State College of Medicine, Penn State Eye Center, Hershey, Pennsylvania, USA

    Jeffrey M. Sundstrom

  2. Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, USA

    David A. Quillen

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Kim, S.K., Kim, R.Y., Dana, M.R. (2022). Graft Versus Host Disease. In: Albert, D.M., Miller, J.W., Azar, D.T., Young, L.H. (eds) Albert and Jakobiec's Principles and Practice of Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-030-42634-7_312

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-42634-7_312

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-42633-0

  • Online ISBN: 978-3-030-42634-7

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation