What is Graft-versus-Host-Disease?

Roughly half of patients transplanted with donor cells develop graft-versus-host disease (GVHD) after transplant. Most cases of GVHD are mild or moderate and resolve over time. However, GVHD can be more severe and, in some cases, life-threatening.

Graft-versus-host disease (GVHD) is a common complication following a transplant using stem cells from a donor (allogeneic transplant). It is NOT an issue for patients who were transplanted with their own stem cells (autologous transplant).

GVHD occurs when the donor's immune system (the graft) perceives the patient's organs and tissues (the host) as unfamiliar cells that should be destroyed. The donor cells that trigger this reaction are a type of white blood cell called T-cells. 

Patients who develop GVHD usually do so within the first year after transplant. However, GVHD can also occur months or years later.

Types of GVHD

There are two forms of GVHD: acute and chronic. A patient may develop one, both, or neither. Although acute and chronic GVHD usually occur during different time periods after transplant, it is possible to have both at the same time. Each has a different effect on organs and tissues. 

Acute GVHD typically affects the:

• skin
• gastrointestinal tract
• liver

Visit the Acute GVHD section of our website for more details about symptoms and treatment for acute GVHD.

Chronic GVHD can affect many more organs. Chronic GVHD most often affects the:

• skin
• eyes
• mouth

 Chronic GVHD can also affect:

• nails, hair, and sweat glands
• joints
• fascia (the connective tissue under the skin that attaches to muscles and other organs)
• liver
• lungs
• genitals
• muscles
• rarely, the nervous system

Visit the Chronic GVHD section of our website for more details about the symptoms and treatments for chronic GVHD.

Treatment Options

GVHD is usually first treated with steroids such as prednisone. If GVHD affects only a single part of the body, like the skin or mouth, a topical steroid, like a cream or oral rinse, may be sufficient to manage the symptoms. If the GVHD is more severe or widespread, systemic steroids that can reach many different organs and tissues may be required.

If steroids are not effective in managing GVHD, several other drugs and therapies are available. Go to the Drugs Used to Treat GVHD section of our website for more details about drugs and other therapies used to treat GVHD.

GVHD and Infection

Many drugs used to treat GVHD can weaken your immune system. This increases your risk of developing a serious infection. You may need to take medication to help prevent infections and be careful about exposing yourself to potential sources of infection while you have GVHD.

Go to the Infection and GVHD section of our website for more details about measures you can take to reduce your risk of developing an infection.

Coping With the Stress of GVHD

Living with GVHD can be a challenging experience for both patients and families. After transplant, everyone wants to resume a normal life, but GVHD can make that difficult for a time.

It's normal to feel anxious or sad while dealing with GVHD. Physical changes, some of the drugs used to treat GVHD, fatigue, or sleep problems can cause depression, confusion, anxiety, mood swings, or exaggerated feelings of anger, excitement, or sadness. It’s important to let your doctor know if you are experiencing any of these symptoms.

Go to the Coping with the Stress of GVHD page on our website for more information about managing emotional challenges associated with GVHD.

GVHD Caregivers

If you are the caregiver for someone who has GVHD, it can be a big job. It's hard to keep on top of all the things you need to do for your loved one who has GVHD while attending to your other daily duties and needs. Although it can be hard to do, it is important to take care of YOUR physical and emotional well-being while caring for your loved one.

Go to the GVHD Caregivers section of our website for more details about being the caregiver for someone with GVHD.