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Graft-versus-Host Disease: everything you need to know

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What is Graft-versus-Host Disease?

Stem cell transplants can provide a cure for a number of blood disorders, cancers and other diseases.

However, no stem cell transplant is without risk.

One common complication, which can be fatal in extreme cases, is Graft-versus-Host Disease (GvHD)

GvHD occurs if the transplanted stem cells view the recipient’s body as foreign and attack it.

It is an autoimmune disorder which can occur at any time following a transplant. It can present itself immediately or days, months and years down the line.

Unlike a rejection, which occurs when the recipient of a transplant attacks the donor cells, in the case of GvHD the donated cells reject the host.

There are two forms:

  • acute GvHD
  • chronic GvHD

Everyone who undergoes a stem cell transplant should be aware of the symptoms and risks of GvHD.

Acute Graft-versus-Host disease symptoms may include:

  • an itchy rash or reddened skin
  • a yellow tinge to skin or eyeballs
  • dry and irritated eyes
  • vomiting and diarrhoea

Chronic Graft-versus-Host disease symptoms may include:

  • all or some of the symptoms for the acute form (above)
  • shortness of breath
  • a fever
  • difficulty or pain when swallowing
  • increased need to urinate
  • burning or bleeding during urination
  • weakness and fatigue

Risk of Graft-versus-Host disease

When a perfectly matched donor can be found, the risk of developing GvHD is much less.

However, not every patient can find a perfect match.

The risk of GvHD increases if a recipient receives stem cells or bone marrow from a mismatched related donor or an unrelated matched donor.

A mismatched related donor is usually a close family member of the patient, such as a parent or sibling, whose human leukocyte antigen (HLA) — markers or proteins on the surface of our cells — only partially matches the recipient patient.

Doctors will usually prescribe preventative immunosuppressive medications after a transplant to stop the donor’s immune cells from attacking the recipient patient.

Various viral, fungal and bacterial infections can be life-threatening to anyone with a suppressed immune system, so medications to mitigate the risk of such infections will also be prescribed.

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