Graft-versus-host disease

Alternative Names

Treatment

The goal of treatment is to suppress the immune response without damaging the new marrow. Medicines commonly used include methotrexate and cyclosporine, either alone or in combination.

High-dose corticosteroids are the most effective treatment for acute GVHD. Antibodies to T cells are given to patients who do not respond to steroids.

Treatment of chronic GVHD includes prednisone (a steroid) with or without cyclosporin (an immune suppressant). If these medicines do not work, experimental treatments are the only option.

Outlook (Prognosis)

How well a person does depends on the severity of the condition. Some cases of GVHD can lead to death.

Many cases, whether acute or chronic, can be treated successfully. Sometimes treatment of the condition can lead to severe complications.

Successful treatment of GVHD does not guarantee that the bone marrow transplant itself will succeed in treating the original disease.

Possible Complications

• Cholestasis
• Moderate-to-severe damage to the liver, lung, or digestive tract
• Severe infection
• Severe lung disease

When to Contact a Medical Professional

If you have had a bone marrow transplant and are no longer in the transplant center, call your health care provider immediately if any unusual symptoms appear, including:

• Diarrhea
• Difficulty breathing
• Skin rash
• Stomach cramps
• Yellowing of the skin or eyes (jaundice)

References

Hoffman R, Benz Jr. EJ, Shattil SJ, et al., eds. Hematology: Basic Principles and Practice. 4th ed. Philadelphia, Pa: Churchill Livingston; 2005:1783-92.

Kasper DL, Braunwald E, Fauci AS, et al. (eds.) Harrison's Principles of Internal Medicine. 16th Edition (Online). New York, NY: McGraw-Hill; 2005.