[4] Graft-Versus-Host Reactions

Abstract

This chapter is concerned with the application of acute GVH reactions as “tools of research,” specifically as in vivo measures of the immunologic competence of lymphoid cells from various sources. It describes graft-versus-host (GVH) reactions as the immunological responses of donor lymphoid cells to foreign histo-compatibility antigens expressed by the host. Thus, just as the ability to reject foreign skin grafts is a measure of immune competence at the organismic level, the ability to mediate GVH reactions is an in vivo measure of immune competence at the cellular level. It reviews that GVH reactions may be considered a special form of adoptive immunity in which cell-surface antigens of the host itself are the targets. The chapter explores that systemic GVH reactions can result in GVH disease, the complex syndrome resulting from the combined effects of GVH reactions, secondary infectious complications, and aberrations of the immune system that is the major obstacle to the more widespread clinical application of bone marrow transplantation. It also provides an overview of the three prerequisites for the induction of GVH reactions: (l) the graft must include a significant number of immunologically competent lymphocytes, (2) the host must express histo-compatibility antigens foreign to the lymphocyte donor, and (3) the host must be, at least temporarily, incapable of rejecting the grafted cells. © 1984, Elsevier Inc. All rights reserved.