Graft versus host disease (GVHD) is a common and occasionally serious complication of an allogeneic bone marrow or stem cell transplant for leukemias and lymphomas.
GVHD may occur within a few days of transplant to many months later. The signs and symptoms of this condition depend, to some extent, on when GVHD manifests itself. Based on the time of occurence, doctors often label GVHD as 'acute' or 'chronic.'
Acute GVHDWhen GVHD occurs within 100 days of a bone marrow or stem cell transplant, it is called an ‘acute’ GVHD. The most common time of occurrence of symptoms of GVHD is between 2 to 6 weeks following the transplant.
Acute GVHD commonly involves the skin, liver, and the intestines.
The most common symptom of GVHD is a skin rash. The rash commonly affects the palms and soles, but can also affect the skin over other parts of the body. In rare circumstances, the skin affection may become severe and result in blisters or peeling of the skin.
Liver affection results in yellowing of the eyes and the skin (jaundice).
Involvement of the intestines may result in cramping pain in the abdomen, diarrhea and blood in the stools.
Chronic GVHDChronic GVHD develops more than 100 days after a transplant. It is more likely to develop in those who show symptoms of acute GVHD, even though it can arise for the first time in patients who have had no signs of GVHD in the first 100 days. Although it may develop many months after a transplant, more than half the cases of chronic GVHD manifest within the first 6 to 8 months of transplant.
The skin, liver, eyes, glands and joints are also commonly affected in chronic GVHD.
Rash and jaundice are common symptoms of chronic GVHD.
Involvement of the eyes may result in dryness and burning sensation.
Muscle and joint affection may cause weakness or a pain and tightening around the joints. Joint deformity may occur in severe cases.
The glands that produce saliva and tears may dry up resulting in dryness of the mouth and the eyes.
Clinical Bone Marrow and Blood Stem Cell Transplantation. Author: Kerry Atkinson and colleagues. Published by Cambridge University Press, 2003.