Ultrastructural Findings in Acute and Chronic Graft‐Vs‐Host Reaction of the Skin*

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Abstract
Two [human] cases of graft-vs.-host reaction (GVHR) after allogeneic bone marrow transplantation were studied by transmission EM. One was observed only in the acute phase and the other, after a mild acute reaction, showed a chronic lichen planus-like pattern. All types of skin damage described in experimental GVHR were confirmed in both cases. An involvement of aggressor lymphocytes against keratinocytes as the chief pathogenetic mechanism of the disease, even in its chronic form, was indicated, although the participation of humoral factors in some phases of the disorder cannot be excluded. The participation of Langerhans cells and macrophages in the reaction was not demonstrated in these cases.