ACUTE INTESTINAL GRAFT-VERSUS-HOST DISEASE IN A SYNGENEIC BONE-MARROWTRANSPLANT RECIPIENT

Background. We report a case of intestinal graft-versus-host disease ( GVHD) in a syngeneic bone marrow transplant patient. Methods. Several days after receiving a bone marrow transplant from his identical twin for treatment of non-Hodgkin's lymphoma, a 47-year-old man developed a skin rash and diarrhea. Results. A colonic biopsy on day +15 revealed characteristic changes of acute intestinal GVHD. Molecular studies (m icrosatellite DNA and HLA sequence-specific primer polymerase chain re action analyses) confirmed the genotypic identity of donor and host an d the improbability of transfusion-associated GVHD. Conclusion. This c ase illustrates that pathological evidence of GVHD does not absolutely require the presence of genetic differences between host and donor an d questions existing concepts about the nature of cyclosporine-induced GVHD.