Learn About Graft Versus Host Disease (GvHD)
Graft-versus-host disease (GVHD) is a potentially life-threatening complication that can occur after certain stem cell or bone marrow transplants.
GVHD; Bone marrow transplant - graft-versus-host disease; Stem cell transplant - graft-versus-host disease; Allogeneic transplant - GVHD
Common conditions include: Chronic Graft Versus Host Disease (cGvHD)
GVHD may occur after a bone marrow or stem cell transplant in which someone receives bone marrow tissue or cells from a donor. This type of transplant is called allogeneic. The new, transplanted cells regard the recipient's body as foreign. When this happens, the cells attack the recipient's body.
GVHD does not occur when people receive their own cells. This type of transplant is called autologous.
Before a transplant, tissue and cells from possible donors are checked to see how closely they match the recipient. GVHD is less likely to occur, or symptoms will be milder, when the match is close. The chance of GVHD is:
- Around 35% to 45% when the donor and recipient are related
- Around 60% to 80% when the donor and recipient are not related
There are two types of GVHD: acute and chronic. Symptoms in both acute and chronic GVHD range from mild to severe.
Acute GVHD usually happens within days or as late as 6 months after a transplant. The immune system, skin, liver, and intestines are mainly affected. Common acute symptoms include:
- Abdominal pain or cramps, nausea, vomiting, and diarrhea
- Jaundice (yellow coloring of the skin or eyes) or other liver problems
- Skin rash, itching, redness on areas of the skin
- Increased risk for infections
Chronic GVHD usually starts more than 3 months after a transplant, and can last a lifetime. Chronic symptoms may include:
- Dry eyes, burning sensation, or vision changes
- Dry mouth, white patches inside the mouth, and sensitivity to spicy foods
- Fatigue, muscle weakness, and chronic pain
- Joint pain or stiffness
- Skin rash with raised, discolored areas, as well as skin tightening or thickening
- Shortness of breath due to lung damage
- Vaginal dryness
- Weight loss
- Reduced bile flow from the liver
- Brittle hair and premature graying
- Damage to sweat glands
- Cytopenia (decrease in number of mature blood cells)
- Pericarditis (inflammation in the membrane surrounding the heart; causes chest pain)
After a transplant, the recipient usually takes medicines, such as prednisone (a steroid), which suppress the immune system. This helps reduce the chances (or severity) of GVHD.
You'll continue taking the medicines until your transplant health care provider thinks the risk for GVHD is low. Many of these medicines have side effects, including kidney and liver damage. You'll have regular tests to watch for these problems.
Stanford Health Care
Robert Negrin is a Hematologist and a Transplant Surgeon in Stanford, California. Dr. Negrin is rated as an Elite provider by MediFind in the treatment of Graft Versus Host Disease (GvHD). His top areas of expertise are Graft Versus Host Disease (GvHD), Acute Myeloid Leukemia (AML), Myelodysplastic Syndrome (MDS), Acute Myeloblastic Leukemia without Maturation, and Bone Marrow Transplant.
City Of Hope Medical Foundation
Stephen Forman is a Hematologist in Duarte, California. Dr. Forman is rated as an Elite provider by MediFind in the treatment of Graft Versus Host Disease (GvHD). His top areas of expertise are Non-Hodgkin Lymphoma, Acute Myeloid Leukemia (AML), Graft Versus Host Disease (GvHD), Bone Marrow Transplant, and Bone Marrow Aspiration.
Trustees Of Columbia University In The City Of New York
Ran Reshef is a Hematologist and a Hematologist Oncology provider in New York, New York. Dr. Reshef is rated as an Elite provider by MediFind in the treatment of Graft Versus Host Disease (GvHD). His top areas of expertise are Graft Versus Host Disease (GvHD), Multiple Myeloma, Non-Hodgkin Lymphoma, Bone Marrow Transplant, and Bone Marrow Aspiration.
The outlook depends on the severity of GVHD. People who receive closely matched bone marrow tissue and cells usually do better.
Some cases of GVHD can damage the liver, lungs, digestive tract, or other body organs. There is also a risk for severe infections.
Many cases of acute or chronic GVHD can be treated successfully. But this doesn't guarantee that the transplant itself will succeed in treating the original disease.
If you have had a bone marrow transplant, contact your transplant provider right away if you develop any symptoms of GVHD or other unusual symptoms.
Summary: The goal of this study is to demonstrate the efficacy of a multidisciplinary group-based telehealth intervention (HORIZONS) compared to minimally enhanced usual care for improving self-management and quality of life for hematopoietic stem cell transplant (HSCT) survivors living with chronic graft-versus host disease, and to identify critical facilitators and barriers for HORIZONS implementation an...
Summary: This is an open-label phase I study of fostamatinib in combination with ruxolitinib for the treatment of chronic GvHD with a suboptimal response to corticosteroids. The primary objective is to identify a minimum safe and biologically effective dose of fostamatinib when combined with standard of care ruxolitinib for the treatment of steroid refractory and steroid dependent cGVHD. The secondary obje...
Published Date: June 17, 2024
Published By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Riwes M, Ferrara JL, Reddy P, Magenau JM. Graft-versus-host disease and graft-versus-leukemia responses. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 109.