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Graft Versus Host Disease (GVHD)

Graft versus host disease occurs when the new stem cells (the graft) recognize the tissues of your body (the host) as foreign and mount an immune attack against them. Symptoms can range from mild and temporary to serious and chronic, and can be life-threatening in some cases.

There are two forms of GVHD

Acute (short-term) GVHD happens in the first 100 days after transplant. It can be prevented by using immune-suppressant medications before, during and/or after the transplant. However, patients may develop GVHD in spite of these medications and will require additional treatment. Steroid therapy is the first line of treatment, but if the patient does not respond, there are alternative therapies available. Photopheresis, which was pioneered at MD Anderson, is a process that separates white blood cells (T lymphocytes) from the rest of the blood and then exposes them to ultraviolet light, which destroys the cells and can ease GVHD symptoms: 

  • Skin rash or itchy, dry skin
  • Diarrhea
  • Liver enzyme and/ or bilirubin abnormalities
  • Nausea
  • Anoxeria
  • Malabsorption of nutrients from the intestinal tract
  • Irritation of the conjunctivae or cornea of the eyes
  • Dry eye syndrome

Chronic (long-term) GVHD may develop from three months to several years after the transplant and affects multiple tissues in the body. Symptoms include:

  • Skin changes such pigment changes and/or hardening or tightening of the skin
  • Joint problems
  • Dry eye syndrome
  • Dry mouth, changes in the mucosa of the mouth
  • Diarrhea
  • Lung problems (wheezing, abnormal pulmonary function tests)
  • Symptoms similar to an auto-immune disorder such as lupus or scleroderma

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