Graft Versus Host Disease (GVHD)

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Graft-Versus-Host Disease (GVHD) Symptom

Itch

Itch is an irritation in the skin that elicits an urge to scratch. Itches are a problem that everyone experiences and can be localized (limited to one area of the body) or generalized (occurring all over the body or in several different areas). Sometimes, depending upon the underlying cause, itching may be worse at night. In medical terminology, itching is known as pruritus.

Graft-versus-host disease (GVHD) facts

  • Graft-versus-host disease (GVHD) is an immune condition that occurs in a patient after transplantation when immune cells present in donor tissue (the graft) attack the host's own tissues.
  • GVHD is a complication after bone marrow transplants (stem cell transplants) from both related and unrelated donors. These types of transplants are called allogeneic transplants.
  • With acute GVHD and chronic GVHD, symptoms can range from mild to severe and life-threatening and often include skin inflammation, jaundice, and GI discomfort along with other organ problems.
  • Acute GVHD usually occurs within the first 100 days after the transplant; the acute form of the disease causes clinical symptoms of skin rash, liver problems, and intestinal symptoms like nausea and diarrhea.
  • Chronic GVHD occurs later; the chronic form of the disease may affect a number of different organs and body systems.
  • GVHD has a complex pathophysiology that involves a number of interactions between the immune cells of the transplant donor and recipient patient.
  • Neither acute nor chronic GVHD can be prevented, although there are measures to help reduce the risk.
  • Immune-suppressing medications are the primary therapy for patients with GVHD, including both corticosteroids and other immune-suppressing drugs.
  • A skin biopsy is often performed to establish the diagnosis of GVHD in a patient with signs and symptoms of the condition.
  • Chronic GVHD is more likely to occur in those who experienced the acute form, but it may also occur in those who never had acute GVHD.
  • Advances in transplant technology are ongoing with the goal of decreasing the incidence of GVHD, including the use of cyclosporine, methotrexate (Otrexup, Rasuvo), and other preventive medications; nevertheless, it is not possible at this time to prevent all cases of GVHD.

What is graft-versus-host disease?

Graft-versus-host disease (GVHD) is an immune condition that occurs after transplant procedures when immune cells from the donor (known as the graft or graft cells) attack the recipient patient host's tissues; the disease is a side effect that is common after an allogeneic bone marrow transplant (stem cell transplant). An allogeneic transplant is one in which a patient receives bone marrow tissue or cells from a donor. Stem cell transplantation is a common treatment for many different cancers (malignancies), including cancers that affect the blood and lymph nodes, as well as some other (non-cancer) conditions that affect the blood or immune system. A stem cell transplant is sometimes performed after a relapse of leukemia or lymphoma that occurs after initial treatment. In addition to bone marrow transplant procedures, GVHD can also occur after transplantation of solid organs that may contain immune system cells such as white blood cells.

Tissues from healthy donors are checked prior to bone marrow transplant to see how closely matched they are to the host's own cells. When there is a close match in certain genetic markers, the risk of the disease is lower. The disease can range from mild to life-threatening in severity. There are two types of GVHD: acute GVHD and chronic GVHD.

The chance of developing GVHD is around 30%-40% when the donor and recipient are related and around 60%-80% when the donor and recipient are not related. The disease can affect many different organs in the body.

Medically Reviewed by a Doctor on 1/27/2017

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