What is Graft Versus Host Disease?
Graft Versus Host Disease (GVHD) is a medical condition that can occur after organ transplantation when donor cells attack the recipient’s tissues.
GVHD most commonly occurs after an allogeneic stem cell or bone marrow transplant. With GVHD, the donor’s immune cells (graft) see the recipient’s body (host) as foreign and mount an immune response against it.
There are two types of GVHD: acute and chronic. Acute GVHD occurs shortly after a transplant, usually within 100 days. Chronic GVHD can appear anytime after the transplant, but symptoms usually appear within two years.
Symptoms of GVHD
GVHD can cause a range of symptoms. For Acute GVHD, symptoms may include a skin rash similar to a sunburn that often begins on the neck, shoulders, ears, palms, and soles of the feet; gastrointestinal issues such as nausea, vomiting, diarrhea, and abdominal cramping; and jaundice.
Chronic GVHD usually affects the skin, GI tract, and lungs. In addition to the symptoms of acute GVHD, people diagnosed with chronic GVHD may also experience skin tightness and swelling, hair loss, dry mouth, gum disease, vision issues, a dry cough, fatigue, muscle weakness or pain, decreased range of motion in joints, and genital issues.
Reasons for GVHD
All cells in the body have human leukocyte antigens (HLAs), which are proteins found on the surface of cells. HLAs are markers that help the body tell the difference between its own cells and unwelcome invaders like viruses and bacteria.
GVHD can occur when the HLAs of the donor do not match the HLAs of the recipient. After a transplant, the recipient’s body creates new cells that have the donor’s HLA rather than those of the recipient. If there is an HLA mismatch between the donor and recipient, these new cells may see the HLAs of the recipient as foreign and launch an attack against the recipient’s tissues.
Preventing & Treating GVHD
The best way to minimize the risk of GVHD is to match HLAs between the donor and recipient as closely as possible. This is accomplished through careful donor screening and matching donor and recipient characteristics as closely as possible.
If GVHD does occur, treatment typically involves immunosuppressive therapy to suppress the immune response and reduce inflammation. In severe cases, additional therapies may be necessary to manage specific symptoms and complications.