Complication Clinical findings Management Acute graft versus host disease (GVHD) Skin Erythematous rash Classic involvement of palms and soles GI tract Colitis, sometimes bloody diarrhea Abdominal pain Liver Elevated bilirubin, alkaline phosphatase, transaminases Hepatomegaly Right upper quadrant tenderness Immunosuppressive medications chosen only in consultation with experts in stem cell transplant Aggressive management of infections and fevers given immunosuppression intrinsic to GVHD Hydration as needed for dehydration from colitis Assessment of anemia secondary to bloody diarrhea Caution using drugs metabolized in the liver if hepatic GVHD present Chronic GVHD Pulmonary Hypoxia Shortness of breath Liver (as above) Eye dryness Mouth dryness Skin Sclerodermatous changes Contractures Infection Bacterial Gram positive Gram negative Viral Endogenous Varicella zoster Herpes simplex Epstein–Barr virus Cytomegalovirus Adenovirus Exogenous Empiric broad-spectrum antibiotics for fever All patients to be considered functionally neutropenic and immunocompromised until they have been off all immunosuppressive medications for at least mo Aggressive imaging to follow-up and localizing