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Acute Graft versus host disease (aGVHD)

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Next Topic: Organ Function

Acute GVHD is a potential complication following an allogeneic stem cell transplant, where donor immune cells (the graft) mistakenly attack the recipient’s healthy tissues (the host).

Common Areas Affected

  • Skin – Rash, redness, burning, or peeling. Often starts on the palms, soles, or trunk

  • Gastrointestinal tract – Nausea, vomiting, abdominal pain, diarrhea, or loss of appetite

  • Liver – Jaundice (yellowing of skin or eyes), abnormal liver function tests

Causes and Risk Factors: GVHD occurs when donor T cells recognize the recipient’s cells as foreign and begin attacking them.

Risk factors include:

  • HLA mismatch between donor and recipient

  • Older age (patient or donor)

  • Donor of a different sex, especially female donors for male recipients

  • Donor history of pregnancy

Treatment Options: Treatment is tailored based on severity and organ involvement. Ongoing monitoring is essential.

  • Immunosuppressive medications

  • Corticosteroids

  • Topical treatments

  • Biologic medications

What I Wish I Knew

  • GVHD can affect internal organs, not just the skin—ask for full-body symptom education

  • Symptoms may appear gradually or overlap with other conditions

  • It’s helpful to understand how GVHD presents differently in each person

  • Ask for links or visuals showing what skin or GI symptoms might look like

Questions to Ask

  • Is GVHD beneficial in fighting residual disease?

  • What are the early signs I should watch for?

  • How does GVHD differ from other post-transplant complications?

  • What are the treatment options if symptoms don’t respond to steroids?

  • Long term monitoring

Common Myths

Myth: “The longer you go, the safer you are and won't get GVHD”

Fact: Not always true. GVHD can develop later, and symptoms may be subtle at first.

Myth: “It only affects the skin”

Fact: GVHD can affect internal organs, and symptoms may not be visible

Helpful Tips

  • Speak up—even if the symptom feels small or vague

  • Keep a daily log of changes in skin, digestion, or energy levels

  • Ask for visuals or examples of what symptoms might look like

  • Don’t wait for symptoms to worsen before calling your care team

Next Topic: Organ Function

Disclaimer: This Journey Map is for educational purposes only. It does not provide medical advice, diagnosis, or treatment. Every patient’s situation is unique, and care decisions should always be made in consultation with your clinical team.

We extend our appreciation to Sanofi and Alexion for their generous partnership and active participation in our community. Their support helped bring patients, caregivers, clinicians, and industry partners together to co-create this Journey Map and improve the transplant experience.

Our Journey Map was created for Patients and Caregivers by Patients and Caregivers. Please share any corrections or additions!