Graft versus Host Disease: From Basic Pathogenic Principles to DNA Damage Response and Cellular Senescence

Figure 1

The upper part of this scheme shows transplant procedure in time with important time points of transplant management. Patients are conditioned with a variety of preparatory regimens. Shortly before graft infusion, GVHD prophylaxis (immunosuppression) is started. Gastrointestinal toxicity occurs during the neutropenic (pre-engraftment) period. Acute GVHD occurs most frequently 30–40 days after engraftment. Later occurrence is typical for late-onset aGVHD, overlap syndrome (features of aGVHD and cGVHD), or cGVHD. GVHD pathogenesis corresponding to transplant time axis is shown in 3 phase-based concepts in the middle of the scheme. Biological processes underlying GVHD pathogenesis are shown at the bottom of the scheme.