Delayed onset of gastrointestinal disease in the recipients of bone marrow transplants. A variant graft-versus-host reaction

Graft-versus-host disease (GVHD) of varying severity occurs in 70% of the patients engrafted with HLA-A-, B-, and D-matched allogeneic bone marrow. Classically, the onset of GVHD occurs between 10 and 50 days post-transplant and is characterized by the development of skin rash followed by hepatitis and/or diarrhea. This report describes a subacute syndrome consisting of anorexia, mouth ulcers, abdominal pain, and diarrhea which occurred in three allogeneic transplant recipients which appears to be distinct from the usual patterns of acute or chronic GVHD.