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Questions and answers

What is GVHD

Graft-versus-host disease (GVHD) is the reaction of a donor’s immune cells against the patient’s tissues after an allogeneic transplant.

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Donor cells approach the tissues
Figure 1.Donor cells approach the tissues

01Short answer

After an allogeneic transplant the donor’s immune cells sometimes see the patient’s body as “foreign” and attack the skin, gut, liver, eyes, mouth and lungs. This is called GVHD. Acute GVHD usually appears in the first months (rash, diarrhoea, jaundice); chronic GVHD appears later (dry skin, mouth and eyes, stiff joints). Preventive medicines are given, and if it develops it is treated. The same mechanism also works against leukemia cells.

02Simple explanation

GVHD is the new immune system being “too watchful”.

Prevention and early treatment are key.

03Scientific explanation

GVHD risk is linked with HLA match, donor type, age and the prevention regimen; current classifications separate acute and chronic forms by clinical features, not by timing.

Treatment uses corticosteroids and several targeted drugs; the transplant team chooses.

04What happens in the body?

Acute GVHD

A rash (often on palms and soles), diarrhoea, abdominal pain, poor appetite, raised liver tests and jaundice. Reported early, it is treated quickly.

Chronic GVHD

Skin changes, dry mouth and eyes, mouth sores, stiff joints and breathing difficulty. Long-term follow-up and several specialists are needed.

Skin, gut and liver
Figure 2.Skin, gut and liver — What is GVHD

What to do

Take preventive medicines as prescribed, protect your skin from the sun and tell your team about every new sign.

Immune balance
Figure 3.Immune balance — What is GVHD

05How GVHD arises

Four steps.

Donor cells arrive — The new immune system starts work.1Donor cells arriveThe new immune system starts work.
Seen as foreign — Tissue markers are recognised.2Seen as foreignTissue markers are recognised.
Organs affected — Skin, gut, liver.3Organs affectedSkin, gut, liver.
Treatment and balance — Medicines calm the reaction.4Treatment and balanceMedicines calm the reaction.
Early recognitionReporting signs quickly helps.
BalancePrevention lowers the risk.

06Key points at a glance

TopicIn brief
Acute GVHDA rash (often on palms and soles), diarrhoea, abdominal pain, poor appetite, raised liver tests and jaundice. Reported early, it is treated quickly.
Chronic GVHDSkin changes, dry mouth and eyes, mouth sores, stiff joints and breathing difficulty. Long-term follow-up and several specialists are needed.
What to doTake preventive medicines as prescribed, protect your skin from the sun and tell your team about every new sign.

07Key terms

GVHD
Graft-versus-host disease.
Prophylaxis
Treatment to prevent a disease.
GVL
The graft-versus-leukemia effect, donor cells attacking leukemia.

08Key points

  • GVHD is a reaction of donor cells.
  • There are acute and chronic forms.
  • Preventive medicines are given.
  • Report new signs quickly.

09Frequently asked questions

Does everyone get GVHD?

No, the risk is individual.

Why is sun dangerous?

Sun can flare skin GVHD; use sunscreen and covering clothes.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Does everyone get GVHD?

  2. Why is sun dangerous?

My questions

12Sources

  1. National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: graft-versus-host disease
  2. National Cancer Institute (NCI). Stem Cell and Bone Marrow Transplants for Cancer
  3. NHS. Stem cell and bone marrow transplants
  4. Anthony Nolan. Understanding stem cell transplants
  5. MedlinePlus (U.S. National Library of Medicine). Histocompatibility antigen test
  6. National Cancer Institute (NCI). Managing Your Care
  7. National Cancer Institute (NCI). Infection and Neutropenia during Cancer Treatment
  8. National Cancer Institute (NCI). Adult Acute Myeloid Leukemia Treatment (PDQ®) — Patient Version
  9. National Cancer Institute (NCI). Chronic Lymphocytic Leukemia Treatment (PDQ®) — Patient Version
  10. National Cancer Institute (NCI). CAR T Cells: Engineering Patients’ Immune Cells to Treat Their Cancers
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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