Graft-versus-host disease

Colonic graft-versus-host disease (high magnification)

Graft-versus-host disease (GVHD) is a serious medical condition that can occur after a stem cell or bone marrow transplant. It is a complication where the donor's immune cells attack the recipient's tissues and organs. GVHD can be acute or chronic, with varying degrees of severity.

Causes

GVHD is caused by the donor's immune cells recognizing the recipient's tissues as foreign and attacking them. This immune response can lead to inflammation and damage in various organs, including the skin, liver, and gastrointestinal tract.

Symptoms

The symptoms of GVHD can vary depending on whether it is acute or chronic. Acute GVHD typically occurs within the first 100 days after transplantation and may present with symptoms such as skin rash, diarrhea, and liver dysfunction. Chronic GVHD can develop months to years after transplantation and may involve symptoms such as skin changes, joint pain, and dry eyes.

Diagnosis

Diagnosing GVHD involves a thorough physical examination, medical history review, and various tests to assess organ function and immune response. Skin biopsies, blood tests, and imaging studies may be used to confirm the diagnosis and determine the severity of the condition.

Treatment

Treatment for GVHD aims to suppress the immune response while preserving the graft's ability to fight off infections. Immunosuppressive medications, such as corticosteroids and calcineurin inhibitors, are commonly used to manage GVHD. In severe cases, additional therapies such as phototherapy, extracorporeal photopheresis, or biologic agents may be considered.

Prognosis

The prognosis for GVHD varies depending on the severity of the condition and the organs involved. Acute GVHD can often be managed effectively with prompt treatment, while chronic GVHD may require long-term management and monitoring. Complications of GVHD can include infections, organ damage, and secondary malignancies.