ABSTRACT
The graft-vs.-host (GVH) reaction was first noted more than a half century ago when
irradiated mice were infused with allogeneic marrow and spleen cells. Although mice
recovered from radiation injury and marrow aplasia, they subsequently died with
“secondary disease,” a syndrome consisting of diarrhea, weight loss, skin changes, and
liver abnormalities (1). This phenomenon was subsequently recognized as GVH disease
(GVHD). In 1966, Billingham formulated the three requirements necessary for GVHD.
First, the transplanted graft must contain immunologically competent cells; second, the
recipient must be incapable of rejecting the transplanted cells; third, the recipient must
express tissue antigens that are not present in the transplant donor that could thus be
recognized as foreign (2).
