II. Pathophysiology

  1. Donor Lymphocytes survive, engraft and react against host tissue

III. Risk Factors: Severe Immunosuppresion

  1. Bone Marrow Transplant
  2. Inherited Cellular Immunity Deficiency
  3. Severe Lymphopenia (<300 to 500 Lymphocytes/ul)

IV. Signs

  1. Onset within 5-10 days of transfusion
  2. Fever
  3. Rash
  4. Nausea
  5. Vomiting
  6. Diarrhea

V. Labs

  1. Liver function abnormalities (acute liver injury )
  2. Pancytopenia
    1. Complete marrow aplasia may occur within 21 days of transfusion

VI. Management

  1. Supportive Care

VIII. Prognosis

  1. Fatal in 90% of cases

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