Clinical Presentation of Mucosal Acute and Chronic Graft-Versus-Host Disease

Graft-versus-host disease (GVHD) may affect any mucosal site and is a significant source of patient morbidity. Acute and chronic GVHD at various mucosal sites share similarities in symptoms, clinical signs, and histopathologic features. Early and accurate diagnosis of GVHD, in conjunction with timely intervention, is key to minimizing discomfort and unnecessary medication exposure, and to preventing irreversible organ damage and functional deficits. In stem cell transplant patients, GVHD must be distinguished from other causes of mucosal inflammation and discomfort, including medication effect, infection, and malignancy. Careful surveillance of mucosal sites is key to prevention, detection, and management of GVHD and other complications of stem cell transplantation. Significant advances in our understanding of the presentation and pathogenesis of GVHD continue to drive further clarification of classification, staging, and management of GVHD at mucosal sites (Figs. 4.1, 4.2, 4.3, 4.4, 4.5, and 4.6; Tables 4.1, 4.2, 4.3, 4.4, 4.5, and 4.6).