Refractory Graft versus host disease
What is Refractory Graft versus Host Disease (GvHD)?
Refractory Graft versus Host Disease (GvHD) is a serious complication of an allogeneic stem cell transplant (allo-SCT) which occurs when the newly transplanted donor immune cells begin to attack the patient’s healthy organs and tissues. It occurs in approximately 25–40% of patients who receive allo-SCT.
GvHD is a potentially life-threatening condition and can affect a variety of organs including the skin, liver, gastrointestinal tract, lungs, and eyes. It can cause significant pain, organ damage and dysfunction, and even death if left untreated.
Symptoms of Refractory Graft vs Host Disease (GvHD)
- Skin rash/lesions
- Itching
- Joint pain, swelling, and stiffness
- Nausea, abdominal cramps, and diarrhea
- Liver inflammation and jaundice
- Fever
- Weight loss
- Dry eyes and mouth
- Difficulty breathing
- Fatigue
Treatment for Refractory Graft Versus Host Disease (GvHD)
The primary goal of treatment for refractory GvHD is to reduce the symptoms and prevent progression of the disease. Patients may be prescribed corticosteroids, immunosuppressive drugs, antibiotics, anti-viral medications, and supportive treatments such as transfusions and nutritional supplements.
High dose intravenous immunoglobulin (IVIG) is another commonly used treatment for refractory GvHD. This type of therapy works to reduce the activity of the donor cells in order to suppress the immune system and reduce inflammation.
Transplantation of the patient’s own stem cells (autologous stem cell transplant) can also be used to treat refractory GvHD. This procedure involves collecting and freezing the patient’s own stem cells prior to the allo-SCT and then re-infusing them into the body once GvHD has developed.
In severe cases, extracorporeal photopheresis (ECP) is sometimes used. This method uses a photoreactive drug to alter the patient’s immune cells prior to re-infusing them into the patient’s body.
Newer treatments, such as antibody-based therapies, are also being used to target specific pathways involved in GvHD. These therapies are often used in combination with immunosuppressive drugs or other therapeutic agents.
Conclusion
Refractory Graft-versus-Host Disease (GvHD) is a serious complication of an allogeneic stem cell transplant that can cause organ damage, dysfunction, and even death if left untreated. Treatment typically involves corticosteroids, immunosuppressive drugs, antibiotics, and other supportive treatments. In some cases, more aggressive therapies, such as antibody-based therapies, may be necessary.