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In these dire times when therapeutics is heavily relying on the advances of personalized medicine, People are gradually opting for regenerative medicine and stem cell transplants along with the usual conventional medications and therapies. Several scientific research and clinical reports have shown success in a wide variety of tissue-damaging disorders with the help of therapies involving stem cell transplant or infusion. For such therapies, healthy stem cells are taken either from themselves or a donor.

What is GVHD?

An autologous transplant means using cells from self, whereas an allogenic transplant means using cells collected from a healthy donor who matches the person’s tissue type. Most commonly, these donors are close relatives, like siblings or parents. Allogenic stem cell transplant presents the patient with a graft-versus-host effect, in which the donor’s graft (bone marrow or peripheral blood stem cells) may affect the host body cells. On a severe note, this effect can also cause a condition known as graft-versus-host-disease (GVHD). GVHD is a potentially life-threatening condition that can cause a range of medical problems.

Causes of GVHD

In GvHD, the donor blood cells attack the recipient’s body cells, which can lead to inflammation.GvHD is an immune response to a foreign body. In the case of GvHD, the foreign body is not the donor cells but the cells of the person receiving the transplant. As target cells of the recipient’s body die and tissue are destroyed by the graft-host reaction, a greater inflammatory response occurs. The chances of GvHD can increase in some conditions like:

  • HLA mismatch
  • The donor is old
  • Opposite gender of the donor
  • Prior genetic problem

Types of GVHD

There are two main types of GvHD

  1. Acute GVHD
  2. Chronic GVHD
  • Acute GVHD

    Acute GVHD is commonly diagnosed within the first 2-3 weeks following an allogeneic stem cell transplant and although it is hard to say exactly how often acute GVHD occurs, some reports say around 20 percent while some reports go up to 80 percent of the times. During the acute GVHD, the donor’s immune blood cells attack the recipient’s healthy cells. Acute GVHD can affect the skin, liver, and gut causing symptoms, such as skin rashes, stomach pain, and vomiting.

  • Chronic GVHD

    Chronic GVHD generally is the severe post-stage of acute GVHD and can occur anywhere between 3 months to more than a year after an allogeneic stem cell transplant. Cases of chronic GVHD can range from mild to severe and can be drastic. Chronic GVHD can lead to hair and skin problems and can also damage organs, such as the liver and lungs. The symptoms are skin rashes, hair loss, mouth ulcers, eye irritation, lung scarring, jaundice, and genital issues.

Diagnosis and Treatment

When faced with side effects like ill-health after stem cell transplant, it is best to consult the doctors. Doctors can diagnose both acute and chronic GVHD after an evaluation of symptoms but a biopsy of a tissue sample from the skin, liver, stomach, intestine, or other sites can ensure the condition.

Although pre-assessment of the risks is the best solution to such a condition, treatments in the form of medications to suppress the immune system or inflammatory reactions, are also available to treat GVHD. The treatment pattern will further depend on whether the GVHD condition is acute or chronic. Another potential form of advanced treatment for such a condition is known as extracorporeal photopheresis, that removes, treats, and reinfuses the patient’s blood.

Take-Home Message

Choosing regenerative medicine or stem cell transplants is the right step towards a developed healthcare facility but one should be aware of these risks such as Graft vs Host Disease before deciding upon a transplant. A thorough discussion should be done with your medical consultant regarding the risk of allogeneic transplants and safety of the suggested transplant therapy. Therefore, it is always a wise decision to consult experienced therapeutic personnel regarding such critical medical issues. For any such queries, you are more than welcome to contact [email protected].

Acute GvHDCauses of GVHDChronic GvHDTypes of GvHD