Graft-versus-Host Disease and Bone Marrow Transplantation

This chapter explains how the discovery of the graft-versus-host disease (GVHD) in experimental animals impinged on the development of therapeutic-bone-marrow transplantation. GVHD was discovered independently by two groups: M. Simonsen in Copenhagen and R.E. Billingham and L. Brent in London. Two Americans, V. Danchakoff and J.B. Murphy, having observed the enlargement of the chick embryo spleen after transplantation of adult chicken tissues such as spleen onto the chorioallantoic membrane, had been close to anticipating GVHD. With improved strategies for conditioning the recipients and treating them after transplantation to avoid or reduce the danger of GVHD, bone marrow transplantation can now be carried out in unrelated but carefully “human leukocyte antigens” (HLA)-matched individuals. However, even in these circumstances, GVHD is always a threat. HLA typing remains mandatory and bone marrow transplantation is one in which tissue typing has made its greatest impact.