Acute Graft-Versus-Host Disease: Diagnostic Challenges and Multidisciplinary Management in the Inpatient Setting

Purpose of Review: Graft-versus-host disease (GVHD) is a common complication of allogeneic hematopoietic stem cell transplantation (HSCT) associated with significant morbidity and mortality. Early diagnosis and treatment is critical for patients with acute GVHD, some of whom will be seen at institutions without dermatology access. We aimed to summarize key points about the pathogenesis of acute GVHD, provide the inpatient physician tools to recognize and evaluate this entity, and discuss the dynamic management of acute GVHD in hospitalized patients. Recent Findings: While topical and systemic corticosteroids remain the first-line treatment for GVHD, second line treatment options for steroid-refractory cases are limited. Summary: In this review, we evaluated the methods of diagnosing acute GVHD, alternative diagnoses to consider, and evidence-based utility and appropriate dosing of various medications, including systemic steroids and other immunosuppressive agents, for the treatment of acute GVHD in an inpatient setting.