A stem cell or bone marrow transplant can result in graft versus host disease (GVHD) when transplanted cells attack the recipient's tissues.
Causes
The donor's immune cells mount an immune response against the recipient's tissues when they recognize them as foreign. As well as genetic and environmental factors, this reaction can be caused by differences in human leukocyte antigens (HLA) between donor and recipient.
Symptoms
The symptoms of GVHD depend on the severity and organs affected. Common symptoms include:
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The rash may cover large areas of the body and be characterized by redness, itching, and blistering.
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Symptoms related to the digestive system include diarrhea, abdominal pain, nausea, vomiting, and loss of appetite.
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Jaundice (yellowing of the skin and eyes), elevated liver enzymes, and liver dysfunction are all liver problems.
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Mouth, throat, and other mucous membranes are involved.
Diagnosis
The diagnosis of GVHD involves a combination of clinical assessment, medical history, and laboratory tests. Diagnostic steps might include:
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Examining the skin, gastrointestinal tract, liver, and mucous membranes for signs of inflammation.
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For the confirmation of GVHD and to rule out other possible causes, tissue samples are collected from affected areas for microscopic examination.
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Monitoring blood cell counts, liver function tests, and other indicators of inflammation or tissue damage with blood tests.
Treatment
Treatment options for GVHD include suppressing the immune response and managing symptoms.
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Medications that suppress the immune system and reduce inflammation include corticosteroids, calcineurin inhibitors, and anti-thymocyte globulin.
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A targeted therapy, such as monoclonal antibodies or cytokine inhibitors, can modulate the immune system.
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In some cases, ultraviolet (UV) light may relieve skin symptoms.
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The provision of supportive measures such as hydration, nutrition support, and pain management to alleviate symptoms and improve overall health.
Prevention
GVHD can be prevented by careful matching of donor and recipient HLA types, as well as other pre-transplant strategies.
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To reduce the risk of GVHD, immunosuppressive medications are administered before and after transplantation.
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GVHD risk can be reduced by choosing the right stem cell source, such as matched sibling donors or umbilical cord blood.
Conclusion
When stem cells or bone marrow are transplanted, graft versus host disease can occur. Symptoms include skin rash, gastrointestinal problems, liver dysfunction, and mucosal involvement. The diagnosis involves clinical assessment, biopsy, and laboratory testing. Immunosuppressive medications, biological therapies, phototherapy, and supportive care are used to suppress the immune response and manage symptoms. GVHD can be prevented with careful matching of donor and recipient, pre-transplant immunosuppressive therapy, and early recognition and prompt intervention.
