Home > Diseases and Conditions > Graft-versus-host disease
  • We are sorry, but NCBI web applications do not support your browser and may not function properly. More information

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Graft-versus-host disease

Last reviewed: June 5, 2012.

Graft-versus-host disease (GVHD) is a complication that can occur after a stem cell or bone marrow transplant in which the newly transplanted donor cells attack the transplant recipient's body.

Causes, incidence, and risk factors

GVHD may occur after a bone marrow or stem cell transplant in which someone receives bone marrow tissue or cells from a donor (called an allogeneic transplant). The new, transplanted cells regard the recipient's body as foreign. When this happens, the newly transplanted cells attack the recipient's body.

GVHD does not occur when someone receives his or her own cells during a transplant (called an autologous transplant).

Before a transplant, tissue and cells from possible donors are checked to see how closely they match the person having the transplant. GVHD is less likely to occur, or symptoms will be milder, when the match is close. The chance of GVHD is:

  • Very low when a person receives bone marrow or cells from an identical twin
  • Around 30 - 40% when the donor and recipient are related
  • Around 60 - 80% when the donor and recipient are not related

Symptoms

There are two types of GVHD: acute and chronic. Symptoms in both acute and chronic GVHD range from mild to severe.

Acute GVHD usually happens within the first 3 months after a transplant. Common acute symptoms include:

Chronic GVHD usually starts more than 3 months after a transplant, and can last a lifetime. Chronic symptoms may include:

  • Dry eyes or vision changes
  • Dry mouth, white patches inside the mouth, and sensitivity to spicy foods
  • Fatigue, muscle weakness, and chronic pain
  • Skin rash with raised, discolored areas, as well as skin tightening or thickening
  • Shortness of breath
  • Vaginal dryness
  • Weight loss

Signs and tests

Several lab and imaging tests can be done to diagnose and monitor problems caused by GVHD.

A biopsy of the skin, mucus membranes in the mouth, or other parts of the body may help confirm the diagnosis.

Treatment

After a transplant, the recipient usually takes drugs that supress the immune system. This helps reduce the chances (or severity) of GVHD.

A number of medicines and other treatments are often started after the transplant. You will continue taking the medicines until your health care provider thinks the risk of GVHD is low. Many of these medicines have side effects, including kidney and liver damage. You will have tests to watch for these problems on a regular basis.

Treatment of chronic GVHD includes prednisone (a steroid), or the same drugs that suppress the immune system.

Expectations (prognosis)

How well a person does depends on the severity of GVHD. The outlook is better for patients who receive closely matched bone marrow tissue and cells

Some cases of GVHD can damage the liver, lungs, digestive tract, or other body organs. Patients may also be at risk for severe infections.

However many cases, acute or chronic, can be treated successfully.

Successful treatment of GVHD does not guarantee that the transplant itself will succeed in treating the original disease.

Calling your health care provider

If you have had a bone marrow or stem cell transplant, call your health care provider right away if you develop any symptoms of GVHD or other unusual symptoms.

References

  1. Sykes M. Transplantation immunology. In Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 48.

Review Date: 6/5/2012.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Corticosteroid regimens for treatment of acute and chronic graft versus host disease (GvHD) after allogenic stem cell transplantationCorticosteroid regimens for treatment of acute and chronic graft versus host disease (GvHD) after allogenic stem cell transplantation
    Corticosteroids are commonly used to treat acute and chronic graft‐versus‐host disease (GvHD) but their effect on length and quality of life of patients has not been studied systematically. In this systematic review, we tried to compare the effect of treatment regimens used for GvHD in the absence and presence of corticosteroids, or with different doses of corticosteroids. After searching relevant sources, we located only two studies that met our criteria to be included in the study. Their results are described in detail in the text of the review. In brief, these studies are in favor earlier remission and slightly better outcome in patients but more evidence is needed in this field.
See all (19) ...

Figures

  • Antibodies.

PubMed Health Blog...

read all...

MedlinePlus.gov links to free, reliable, up-to-date health information from the National Institutes of Health (NIH) and other trusted health organizations.

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...