Graft versus Host Disease (GVHD) is a complication of stem cell transplant (SCT). It happens when the donor stem cells (the graft) try to reject your body (the host). GVHD can be either
acute (within 3 months of transplant) or
chronic (3 months or later after transplant). Each of these types of GVHD can be mild or severe. Early signs include changes to your skin, stomach/bowel, and liver.
Acute GVHD can happen during the first 100 days after transplant. Since it is important to treat GVHD as soon as possible, you will be watched closely for any early signs of GVHD. You will also have to watch for signs of it even after you are home. Acute GVHD will be treated as soon as the first symptoms appear. It is usually treated with steroids (e.g., prednisone) and/or other drugs (immunosuppressants) that suppress the immune system.
Severe GVHD can be life-threatening. Treating GVHD right away is the best way to control the disease. With time, most GVHD symptoms usually respond to treatment or get better on their own. Sometimes, even when treated early, GVHD does not go away.
One of the first blood tests you and your donor had done was HLA typing (tissue typing). This was done to find the donor with the closest tissue type to yours. However, there are more differences between you and your donor that tests cannot find. It is these differences that the new donor cells recognize. It is believed that one type of white blood cell that fights infection may see your tissue cells as being different and begin to attack them. Usually, the more difference (mismatch) there is in HLA between you and your donor, the greater the risk there is of GVHD.
Mild GVHD may not always be a disadvantage. In people who have cancer, we know that GVHD, especially chronic GVHD, may have an anti-tumour effect. This means that your new stem cells are looking at your “old” blood cells as foreign and attacking them.
Other than trying to find the best donor for you, you will take medicine to prevent GVHD. These include:
Stomach or Bowel:
Patients who have acute GVHD are more likely to develop the chronic form later on. Usually, the worse the GVHD, the more symptoms you will have.
Chronic GVHD is seen in about half of patients that have donor SCT. It can start months to years after SCT. The cause isn’t known. It is more likely to happen in people that had acute GVHD. Both chronic GVHD and the drugs used to treat it may reduce how well your body fights infection.
If you have chronic GVHD you may have symptoms of acute GVHD. There are other symptoms that can affect you. Chronic GVHD needs to be treated as soon as the first symptoms appear. It is usually treated with meds like prednisone and cyclosporine. Other treatments include:
When the lining of the stomach or bowel is affected, you may have:
Mouth:When your mouth is affected, you may have:
Current as of: October 30, 2017
Author: Blood and Marrow Transplant Program, Alberta Health Services
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