Graft versus Host Disease
Graft versus Host Disease (GvHD) is a condition that can be experienced by someone who transplants bone marrow or stem cells. In mild GvHD, the condition can heal by itself. However, if the GvHD suffered is classified as severe and already feels disturbing, treatment must be done immediately, because it can trigger the appearance of symptoms in the form of inflammation of the skin, vision problems, to shortness of breath.
Causes of Graft versus Host Disease
The main factor triggering GvHD is the incompatibility of HLA (human leukocyte antigen) in stem cells or donor bone marrow implanted into the recipient. HLA is a molecule found on the surface of body cells and has an important role in the immune response to foreign substances in the body. In other words, patients who accept donors with HLA who are not in accordance with their bodies have a high risk of developing GvHD.
The risk of suffering from GvHD will increase if:
Symptoms of Graft versus Host Disease
Symptoms that appear can differ depending on the type of GvHD suffered. GvHD is divided into 2 types based on symptoms that appear, namely acute and chronic. In the medical realm, the acute term signifies that a patient's condition occurs in a relatively short time. While chronic occurs in a longer period of time.
In patients with acute GvHD, symptoms usually appear within 100 days after a transplant is performed. Some of the symptoms that appear in patients with acute GvHD can be:
Inflammation of the skin, such as itching, redness, and a rash that feels painful.
Hepatitis. This condition can trigger symptoms such as jaundice, and even potentially cause liver failure.
Enteritis or inflammation of the digestive tract. Symptoms include diarrhea, nausea, vomiting, abdominal pain, cramps, and bloody stools.
Whereas in chronic GvHD, symptoms that can be experienced include:
Diagnosis of Graft versus Host Disease
In diagnosing this condition, the doctor will initially make observations on the symptoms that appear. Then, the doctor can also continue the examination by doing a biopsy.
The doctor will take samples to be tested in the laboratory. The location of sampling may differ depending on the symptoms that emerge. If symptoms appear in the form of inflammation of the skin, the doctor will take samples that are in the skin, such as dry skin peeling.
In addition, several tests can also be done to help the diagnosis process. These tests include:
GvHD will generally recover on its own within a year or more after a transplant is performed. However, if the conditions experienced are very disturbing or classified as severe, treatment can be done by administering drugs.
Medications commonly given are a combination of corticosteroids (for example prednisolone, methylpredinisolone) and immunosuppressive drugs (for example ciclosporin). If corticosteroids have no effect on the development of the condition, the doctor can prescribe nonsteroidal drugs to treat the patient's condition.
Some nonsteroidal drugs commonly used to treat GvHD include:
The doctor can also prescribe antibiotics to minimize the risk of infection. Discuss again with your doctor about the benefits and risks. The doctor will determine the appropriate dosage and prevent the risk of side effects from the drugs used.
Complications of Graft versus Host Disease
Complications that can occur vary for each person. Some of the complications caused by suffering from this condition include:
See your doctor immediately if other symptoms arise that are bothersome.
Prevention of Graft versus Host Diseases
There is no method that can definitely prevent GvHD. Doctors will usually give drugs that play a role in reducing the immune response, such as ciclosporin and tacrolimus, to patients who undergo transplantation. Avoid using drugs without doctor's advice, and discuss in detail with your doctor about the benefits of bone marrow transplantation and how to reduce the risk.
The main factor triggering GvHD is the incompatibility of HLA (human leukocyte antigen) in stem cells or donor bone marrow implanted into the recipient. HLA is a molecule found on the surface of body cells and has an important role in the immune response to foreign substances in the body. In other words, patients who accept donors with HLA who are not in accordance with their bodies have a high risk of developing GvHD.
The risk of suffering from GvHD will increase if:
- Donors are women who have been pregnant.
- Receive donors when old age, or get an old donor.
- The donor carries cytomegalovirus in his body.
Symptoms of Graft versus Host Disease
Symptoms that appear can differ depending on the type of GvHD suffered. GvHD is divided into 2 types based on symptoms that appear, namely acute and chronic. In the medical realm, the acute term signifies that a patient's condition occurs in a relatively short time. While chronic occurs in a longer period of time.
In patients with acute GvHD, symptoms usually appear within 100 days after a transplant is performed. Some of the symptoms that appear in patients with acute GvHD can be:
Inflammation of the skin, such as itching, redness, and a rash that feels painful.
Hepatitis. This condition can trigger symptoms such as jaundice, and even potentially cause liver failure.
Enteritis or inflammation of the digestive tract. Symptoms include diarrhea, nausea, vomiting, abdominal pain, cramps, and bloody stools.
Whereas in chronic GvHD, symptoms that can be experienced include:
- Vision loss.
- Dry eyes or mouth.
- Trouble swallowing.
- There are white patches in the mouth.
- Mouth pain.
- Stomach ache.
- Loss of appetite, to weight loss.
- Jaundice or jaundice.
- Sneezing or shortness of breath.
- Fatigue.
- Hair loss.
- Rash.
- Skin discoloration.
- Dry vagina.
Diagnosis of Graft versus Host Disease
In diagnosing this condition, the doctor will initially make observations on the symptoms that appear. Then, the doctor can also continue the examination by doing a biopsy.
The doctor will take samples to be tested in the laboratory. The location of sampling may differ depending on the symptoms that emerge. If symptoms appear in the form of inflammation of the skin, the doctor will take samples that are in the skin, such as dry skin peeling.
In addition, several tests can also be done to help the diagnosis process. These tests include:
- Blood test
- Kidney function test
- Kidney ultrasound
- Lung function test
- Schirmer test. One symptom of GvHD is dry eyes. This test is done to detect abnormalities in the tear production process that can be caused by GvHD.
- Barium swallow test, a test that is done to detect the cause of pain when swallowing, abdominal pain, vomiting mixed with blood, and weight loss.
GvHD will generally recover on its own within a year or more after a transplant is performed. However, if the conditions experienced are very disturbing or classified as severe, treatment can be done by administering drugs.
Medications commonly given are a combination of corticosteroids (for example prednisolone, methylpredinisolone) and immunosuppressive drugs (for example ciclosporin). If corticosteroids have no effect on the development of the condition, the doctor can prescribe nonsteroidal drugs to treat the patient's condition.
Some nonsteroidal drugs commonly used to treat GvHD include:
- Infliximab
- Tacrolimus
- Mycophenolate mofetil
- Etanercept
- Thalidomide
The doctor can also prescribe antibiotics to minimize the risk of infection. Discuss again with your doctor about the benefits and risks. The doctor will determine the appropriate dosage and prevent the risk of side effects from the drugs used.
Complications of Graft versus Host Disease
Complications that can occur vary for each person. Some of the complications caused by suffering from this condition include:
- Pneumonia
- Thrombocytopenia
- Anemia
See your doctor immediately if other symptoms arise that are bothersome.
Prevention of Graft versus Host Diseases
There is no method that can definitely prevent GvHD. Doctors will usually give drugs that play a role in reducing the immune response, such as ciclosporin and tacrolimus, to patients who undergo transplantation. Avoid using drugs without doctor's advice, and discuss in detail with your doctor about the benefits of bone marrow transplantation and how to reduce the risk.
0 Response to "Graft versus Host Disease"
Post a Comment