Information for Patients

Chronic Graft-versus-host disease

What is chronic graft-versus-host disease?

Chronic GVHD usually begins later after transplant and lasts longer than acute GVHD. Patients with Chronic GVHD may present with a wide variety of symptoms. Skin rash and/or mouth sores are among the most common initial signs of the disease. The rash is often slightly raised and may be itchy. Unlike acute GVHD, chronic GVHD can cause damage in the glands that produce tears in the eyes and saliva in the mouth resulting in dry eyes or a dry mouth. Patients may have mouth ulcers causing pain while eating, skin rashes, or liver inflammation. Chronic GVHD can also cause many other problems. One such problem is formation of scar tissue in the skin (cutaneous sclerosis) and joints. Another such problem is damage to air passages in the lungs (bronchiolitis obliterans syndrome).

Who gets chronic graft-versus-host disease?

Patients who have had a blood or marrow stem cell transplant from another person (this is called an allogeneic transplant) can get chronic GVHD. Patients who have had acute GVHD have a greater risk of developing chronic GVHD. Older patients, patients who received a peripheral blood (instead of bone marrow) transplant, and patients who had a mismatched or unrelated donor have a greater risk of chronic GVHD.

What causes chronic graft-versus-host disease?

The exact cause of chronic GVHD is not known. It is likely that it is a complicated disorder due to difficulty of the new immune system (from the donor) maturing in the host (the patient).

How is chronic graft-versus-host disease diagnosed?

Chronic GVHD is most often diagnosed by the characteristics of the rash or by changes in the eyes or mouth. Chronic GVHD can also be diagnosed by characteristic symptoms or signs involving many other organs and sites including joints and connective tissues, lungs, esophagus, stomach, intestines, liver, and vagina, among others. The diagnosis is usually confirmed by looking at a small piece of skin with a microscope. If the skin is not affected, other tests can be used to confirm the diagnosis in other organs and sites.

What is the treatment for chronic graft-versus-host disease?

Prednisone or other similar anti-inflammatory or immunosuppressive medications are used to treat chronic graft-versus-host disease. Other immunosuppressive medications can be used if treatment with prednisone is not successful.