GRAFT VERSUS HOST DISEASE

GRAFT VERSUS HOST DISEASE

Graft versus host disease (GVHD) is an immune condition that can occur in a patient after he/she has undergone an allogeneic transplant.  The immune cells present in the donor’s tissue or the graft attack the host’s tissues. Furthermore, the donated bone marrow or peripheral blood stem cells view the recipient’s body as foreign, and the donated cells/bone marrow might lead a response against the tissues and organs of the recipient. 

This health problem is a side effect that is common after an allogeneic bone marrow transplant or stem cell transplant. An allogeneic transplant is one in which a patient receives bone marrow tissue or cells from a donor. 

Thus, this article will deal with the information on the risk factors and effects brought by graft versus host disease. Its definition, types, symptoms as well as the diagnosis and treatments. 

GVHD is indeed a very harmful disease if not properly diagnosed. Since a foreign stem cell from the donor is injected into the recipient’s body, it is not quite a surprise if certain effects were to occur. 

Since the organs of the recipient are not so familiar with the newly transferred foreign cell so it might react differently, however, this can only happen from few to none with specific conditions. Hence, this article had discussed the after-effects of graft versus host disease after transplantation had been done to the recipient’s body. Its different types, symptoms, how it is diagnosed, and especially the common treatments.

TYPES 

A patient who has undergone an allogeneic transplant might experience either from both types of GVHD or neither.

These are the two main types of GVHD:

  • Acute graft versus host disease (aGvHD). It typically occurs within 100 days after the transplantation. Also, this condition might appear early or suddenly after the surgery. 
  • Chronic graft versus host disease (cGvHD). This type of GvHD refers to a condition that can develop over time. 

 

SYMPTOMS

Symptoms may vary depending on what type of graft versus host disease the patient has developed. Hence, these are the symptoms sorted for each type:

Acute GvHD

  • Skin rash or reddened areas on the skin, especially if it is itchy.
  • Yellow discoloration of the skin and eyes, and not normal blood test results. 
  • Nausea, vomiting, diarrhea, or abdominal cramping can be associated with the gastrointestinal tract. 

Chronic GvHD 

  • Rash, raised, or discolored areas, thickening or tightening of the skin
  • Abdominal swelling, yellow discoloration of the skin and eyes, and not normal blood test results. (liver-related)
  • Dry eyes or vision changes (eye-related)
  • Dry mouth, white patches inside the mouth, pain or sensitivity to spicy foods. (oral-related)
  • Shortness of breath or changes is seen on your chest X-ray. (pulmonary-related)
  • Difficulty swallowing, pain with swallowing, or weight loss. (gastrointestinal-related)  
  • Fatigue, muscle weakness, or pain. (neuromuscular-related)
  • Vaginal dryness or pain with intercourse. 
  • Decreased range of motion in joints or tightness in joints.

DIAGNOSIS

These are the ways on how physicians will diagnose a patient who is showing symptoms.

  • A tissue biopsy
  • A test will be used to diagnose GVHD when the patient’s clinical signs and symptoms suggest that GVHD is present.
  • Biopsies from other sites in the body are done instead of or in addition to the skin biopsy.
  • Blood tests include blood cell counts and blood chemistry profiles. 
  • Blood tests that assess liver function are also commonly performed. 

 

TREATMENT

One of the reliable steroid-related treatments is immunosuppressant medications, corticosteroid drugs like prednisolone or methylprednisolone, and more advanced medications and techniques that reduce the immune response. Corticosteroids are the mainstay of therapy, but other medications may be added or given when the GVHD does not respond well to steroid treatment.

 

For non-steroid immune-suppressing drugs and treatments include: 

  • Antithymocyte globulin (Thymoglobulin)
  • Denileukin diftitox (Ontak)
  • Daclizumab (Zenapax)
  • Infliximab (Remicade)
  • Sirolimus (Rapamune)
  • Tacrolimus (Prograf)
  • Mycophenolate mofetil (CellCept)
  • Extracorporeal photopheresis (ECP) – a treatment that involves a combination of leukapheresis and photodynamic therapy, in which patient blood is exposed to a sensitizing agent followed by ultraviolet.

 

These treatments might cause some unforeseen side effects; nevertheless, it depends on how the medication will react to the host body.

Related Articles

TETRALOGY OF FALLOT

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Tetralogy of Fallot is a congenital heart defect that affects the [...]

TRICHINOSIS

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Trichinosis, also known as trichinellosis, is a parasitic infection caused by [...]

TRIGEMINAL NEURALGIA

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Trigeminal neuralgia is a neurological condition characterized by severe facial pain. [...]