Graft Versus Host Disease (GVHD) (The James)

Graft Versus Host Disease (GVHD) (The James)

Graft Versus Host Disease (GVHD) is a problem that can occur after allogeneic bone marrow transplants (BMT). About 40-50% of patients may have this problem. It is more common in matched unrelated or mismatched transplants. This handout gives general information about GVHD.

 

What causes GVHD?

GVHD is a response of your immune system. It is caused by the immune cells or “lymphocytes” of the new bone marrow you received. These lymphocytes see your body cells as being different and may attack and destroy your body cells. This is called graft versus host disease.

Graft versus host means:

  • Graft - the bone marrow, stem cells or lymphocytes you receive from a donor.
  • Versus - against
  • Host - your own body cells

 

Types of GVHD

There are two different types of GVHD: Acute and Chronic

  • Acute GVHD
    • Acute GVHD may develop within 3 months after your BMT, when your blood counts start to improve. Most often, it affects your skin, gastrointestinal (GI) tract and liver. The symptoms of acute GVHD happen quickly and can be mild or severe.
  • Chronic GVHD
    • Chronic GVHD may occur 3 to 12 months or longer after your BMT. Chronic GVHD symptoms start slowly and can be mild or severe. Most symptoms are mild and can be controlled by medicines.

The chart below lists the most common symptoms of Acute and Chronic GVHD:

GVHDSkinGI TractLiverLungsEyes
Acute
  • Redness of palms of hands and soles of feet
  • Body rash
  • Sensitive, itching skin or dry skin
  • Diarrhea
  • Nausea
  • Loss of appetite
  • Abdominal cramps
  • Enlarged liver
  • Increased liver function tests* (bloodwork)
  • Abdominal tenderness
  
Chronic
  • Darkened and dry skin
  • Peeling of skin
  • Body rash 
  • Diarrhea
  • Weight loss
  • Difficulty eating or loss of appetite 
  • Dry mouth
  • A gradual increase in liver function tests* (bloodwork)
  • Enlarged liver
  • Abdominal tenderness
  • Yellowish color of skin and eyes
  • Hard to hard deep breaths
  • Shortness of breath
  • Dry eyes
  • Sensitivity to light

*Liver function tests - bloodwork that allows us to see how the liver is working. 

 

Prevention/Treatment

Medicines are used to prevent acute and chronic GVHD. These medicines are started during your BMT to slow down or suppress your immune system. If needed, your doctor may also order these medicines to help with your GVHD symptoms. The most common GVHD medicines used include the following:

  • Tacrolimus (Prograf)
  • Mycophenolate (Cellcept)
  • Methotrexate
  • Cyclophosphamide (Cytoxan)
  • Steroids

Your doctor or nurse will give you more information about the prevention and treatment of GVHD.

 

 

© February 3, 2022. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.