Your body’s cells are perceived as a threat and an attack by the donor stem cells you receive during an allogeneic stem cell transplant in Graft-Versus-Host disease (GvHD). Acute and chronic GvHD are the two primary forms of GvHD. Medications that suppress (slow down) your immune system are part of the treatment.
Graft versus host disease (GvHD) – What is it?
GvHD is a potential side effect of receiving a bone marrow or stem cell transplant from someone else. As many cancer cells as feasible must be destroyed in order to replace them with healthy stem cells during a transplant.
Extremely high dosages of chemotherapy and occasionally other therapies like radiation are used during transplants. In addition to killing cancer cells, the high dose treatment also destroys your bone marrow’s stem cells.
You receive a drip of healthy stem cells following the high dose treatment. The healthy stem cells enter your bone marrow and begin producing the blood cells you require once more.
The source of the stem cells is the distinction between a bone marrow transplant and a stem cell transplant. Blood stem cells are used in a stem cell transplant.
Another name for this is a PBSCT, or peripheral blood stem cell transplant. Stem cells taken straight from the bone marrow are used in bone marrow transplants.
An allogeneic transplant, often known as a donor transplant, is a transplant from another individual. An autograft, also known as an autologous transplant, is a transplant that uses your own stem cells.
One potential side effect of receiving a donation from someone else is GvHD.
What kinds of GvHD are there?
Graft-Versus-Host disease comes in two primary varieties. In the past, medical professionals categorized GvHD according to the onset of symptoms.
More recently, in addition to the timing of symptom onset, physicians now use clinical signs and symptoms (such as test or imaging results) to determine the precise type of GvHD.
- Acute Graft versus Host Disease (aGvHD): aGvHD usually manifests within the first 100 days following transplantation. However, aGvHD symptoms can also appear later. Most frequently, aGvHD affects the liver, GI tract, or skin.
- Chronic Graft-Versus-Host disease – Although it can develop at any point following an allogenic transplant, the majority of instances of chronic graft versus host disease (cGvHD) begin within two years. Your skin, mouth, liver, lungs, GI system, muscles, and joints may all be impacted by chronic GvHD.
How does Graft-Versus-Host disease develop?
GvHD indicates a host-reactive graft. The donor’s bone marrow or stem cells make up the graft. The recipient of the transplant is the host.
GvHD occurs when specific white blood cell (T cell) subtypes in bone marrow or donor stem cells target your own body cells. This is because the graft, or donated cells, assault the host, or your own cells, because they perceive them as alien.
Because T cells recognize proteins on our own cells known as human leukocyte antigens (HLA), they often do not assault our own cells. Our parents pass on our HLA to us. HLA is specific to each individual, with the exception of identical twins.
You and your donor undergo blood testing prior to a transplant to determine how closely your HLA matches. This test is known as tissue typing. GvHD risk is reduced if your donor and you share a high degree of HLA similarity. Your risk of developing GvHD increases with the degree of discrepancy between your donor’s and your own HLA.
Following a transplant, your bone marrow begins using the donor stem cells to produce new blood cells. The donor’s HLA pattern is present in these new blood cells. They may start attacking parts of your biological cells because they recognize the HLA pattern on them as different (foreign).
Conclusion
During a physical examination, your doctor can make the diagnosis of Graft-Versus-Host disease by looking at particular symptoms and analyzing the findings of lab work and a biopsy. A biopsy involves a healthcare professional taking a sample of tissue or cells and sending it to a laboratory for analysis.
Many patients with aGvHD are successfully treated by medical professionals using more immunosuppressive medications, such as topical (applied to the skin), intravenous (given through a vein), or oral (given by mouth) corticosteroids.
