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Background: Acute graft-versus-host disease (GVHD) following allogeneic hematopoietic stem cell transplant (AHscT) is an immune triggered process, leading to profound immune dysregulation and organ dysfunction. Three phases summarize the development of the immunopathophysiology of acute GVHD: an afferent phase, an efferent phase and an effector phase. A panel of plasma biomarkers including IL-2-receptor-a, TNF receptor-1, IL-8, and hepatocyte growth factor has been suggested as a confirmatory tool for the diagnosis of acute GVHD at the onset of clinical symptoms and to provide prognostic information independent of GVHD severity. Initial therapy for acute GVHD ranges from a simple observation or a trial of topical corticosteroids for skin GVHD of stage Ι or ΙΙ, to systemic treatment in patients with grade ΙΙ-ΙV acute GVHD. Objectives: The aim of this work is to summarize the most recent available data concerning acute graft versus host disease from biology, immunopathogenesis, diagnosis and therapy. Material and Methods: We searched the PubMed and Google scholar databases for relevant studies acute graft-versus-host disease an immunologic perspective. Conclusion: Acute graft versus host disease (aGVHD) remains the second leading cause of death following allogeneic hematopoietic stem cell transplant (AHSCT). Over the last five years, the progress in understanding the pathophysiology of this immune based-process helped redefine graft versus host reaction and opened new possibilities for novel preventive and therapeutic approaches.

Acute Graft-versus-Host Disease: An Immunologic Perspective