KEEPING AN EYE ON GVHD

What is GVHD and does it happen to everyone?

After having a bone marrow or stem cell transplant, some patients will develop graft versus host disease (GVHD).  Graft versus host disease (GVHD) is the term used when this new immune system from the donor attacks your body.  

 

It is difficult to predict before the transplant exactly who will get GVHD and to what extent. When donors are matched to patients, whether related or unrelated donors, laboratory work aims to provide the best match possible. This work can attempt to predict the risk of GVHD and can enable doctors to choose the best available donor for the transplant. 

What are the Signs and Symptoms of GVHD?

 Acute GVHD: In the early weeks and months after your transplant (usually within the first four months) you might notice a rash, or an upset stomach with nausea, vomiting or diarrhea, or it could affect your liver tests, sometimes causing jaundice (yellow discoloration to skin).   


Chronic GVHD:  Can happen few months after transplant and can reoccur for several years after transplant. Like acute GVHD, it may affect your skin, gut, liver or mouth. But it can also affect other parts of your body, such as your eyes, lungs, vagina and joints. Chronic GVHD may be mild or severe, and for some people can go on for several months or even years. 

 

The most common joints that are affected in GVHD are:

Wrist

Fingers

Elbow

Ankles 

Hips 

How is GVHD diagnosed?

‘’Some GVHD may be a good thing because it means that your new immune system is working and is likely to be attacking any remaining disease cells. This can help stop the disease coming back. You might hear this called graft versus tumour effect’’.  


As a patient, it's always good to keep an eye on any changes you notice in the body and make notes, inform the medical team. Although not definite but some early signs might be clawing of the fingers in hand, reduce in ankle movement, skin changes and pain in the joints. 


Your doctor can diagnose GVHD from your symptoms, as well as from results of laboratory tests and tissue samples. The early symptoms of GVHD are often the same as some side effects and complications after a transplant, so diagnosing GVHD can be hard. Before your doctor can make a diagnosis, your medical team will first make sure that there are no other reasons for the symptoms. 


You can help your medical team by immediately reporting changes in your symptoms or about the onset of new symptoms.