G

gammaglobulin A solution of immunoglobulins
collected from the PLASMA of donated BLOOD or
from donated plasma. The highest concentration is
of IMMUNOGLOBULINE (IgE). Health-care providers
administer gammaglobulin by intramuscular or
intravenous injection to provide rapid immune
protection for exposure to infectious diseases such
as HEPATITIS. Though the protection is temporary, it
helps prevent INFECTIONuntil the person’s IMMUNE
SYSTEM can produce the necessary antibodies.
Gammaglobulin is the treatment of choice when
there is widespread public exposure to infectious
diseases, such as may occur in schools and day-
care centers.
See alsoANTIBODY; ANTIGEN; IMMUNITY.

graft vs. host disease A life-threatening condi-
tion in which the immune cells (leukocytes and
lymphocytes) contained in allogeneic transplanted
BONE MARROW(the graft, from a donor source) pro-
duce antibodies that attack other organs in the
organ transplant recipient’s body (the host). BONE
MARROW TRANSPLANTATION(or BLOOD STEM CELLtrans-
plantation) is the primary treatment for cancers of
the BLOODsuch as LEUKEMIA, lymphoma, andMULTI-
PLE MYELOMA. Doctors may also use bone marrow
transplantation to treat some types of cancer that
do not respond to other therapies, severe aplastic
ANEMIA, and severe SICKLE CELL DISEASE.
Graft vs. host disease is not a threat with autol-
ogous (self) bone marrow transplantation, which
re-infuses blood stem cells previously withdrawn
from the person. The condition occasionally devel-
ops after solid ORGAN TRANSPLANTATION and in
IMMUNOCOMPROMISED people who receive BLOOD
TRANSFUSIONS.
The immune cells of the transplanted bone
marrow generate antibodies that commonly attack

the recipient’s LIVER, gastrointestinal tract (espe-

cially the STOMACHand SMALL INTESTINE), and SKIN.

Damage can be rapid and severe. When the condi-

tion involves multiple organs, as is common, cata-

strophic multiple system failure is very possible.

Graft vs. host disease accounts for more deaths

after 100 days past the bone marrow transplanta-

tion than any other cause, including the cancer

under treatment.

Symptoms and Diagnostic Path

Acute graft vs. host disease occurs within 100 days

after the transplantation. About 30 percent of

bone marrow transplant recipients experience

acute symptoms, which may include

• skin RASH


• DIARRHEA


• INFECTION

Chronic graft vs. host disease develops or con-

tinues beyond 100 days from transplantation,

though typically chronic disease tends to first

manifest between 3 and 12 months after the

transplant. The perpetual attacks that are the hall-

mark of chronic graft vs. host disease result in

fibrotic (SCAR-related) changes to the skin, liver,

and LUNGS. About 70 percent of people who

receive bone marrow transplants experience some

degree of chronic symptoms, which typically

include

• dry, itchy skin


• discolored or taut skin


• HAIRloss or graying


• weight loss


• shortness of breath with exertion (DYSPNEA)

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