Allogenic Transplant: Graft versus Host Disease
Every patient who receives a stem cell transplant from a donor—called an allogeneic transplant—will experience some degree of graft versus host disease. GVHD happens because the new stem cells from the donor (the “graft”) view the cells in the patient (the “host”) as foreign. The graft cells then attack the host, causing a variety of acute or chronic symptoms.
While GVHD can be severe and even debilitating, it is actually an essential step forward in a successful stem cell transplant and recovery. In the absence of GVHD, cancer is much more likely to recur. The key to a successful stem cell allogeneic transplant is finding the critical middle ground where the donor and patient cells can learn to exist side-by-side.
Getting the Right Help, Right Away
The only accredited adult stem cell and cellular therapy program in metropolitan Washington, D.C., MedStar Georgetown can treat even the most severe cases of GVHD. With a dedicated outpatient facility, comprehensive care coordination, and a commitment to treat the whole person, our specialists partner with our patients, every step of the way.
As part of the Lombardi Comprehensive Cancer Center, the only NCI-designated comprehensive center in the area and one of only 49 nationwide, we also offer patients access to the most forward-thinking new approaches and therapies to minimize GVHD.
Patients with leukemias or some forms of lymphomas need an allogeneic stem cell transplant—basically an immune system replacement—because their own immune system failed to recognize and kill their cancer.
To prepare for the transplant, patients first go through specialized conditioning treatments to eliminate as many existing cancer cells as possible while priming the body to accept the new stem cells. Immunosuppressive drugs, typically taken for six months, further clear the way for the new donor stem cells to take hold and flourish.
For a successful engraftment, a carefully balanced tension between graft and host must be established and maintained, especially during the first year following transplant. Over time, graft and host will learn to accept one another and coexist.
When that delicate balance is upset, however, GVHD can get the upper hand.
Symptoms and Complications
Graft versus Host Disease (GVHD) can cause serious and complex complications in virtually every part of the body, including:
- Gastrointestinal tract
- Neuromuscular system
The most common symptoms are:
- Skin rash
- Dry eyes
- Joint pain or stiffening
- Loss of appetite
- Nausea, vomiting or diarrhea
At its worst, GVHD can be debilitating, affecting quality of life. Most GVHD occurs within 90 days after allogeneic transplant.
To detect potential disease in its earliest stage, the experts at MedStar Georgetown monitor patients regularly during the first six months post-transplant. Such frequent follow-up allows for timely intervention and, if needed, referral to specialists to minimize symptoms and complications.
Unfortunately, GVHD can recur at any time, requiring constant vigilance on the part of both patients and providers. Toward that end, MedStar Georgetown’s Stem Cell Transplant and Cellular Immunotherapy Program program maintains a lifelong relationship with our patients, assuring the earliest detection of GVHD flare-ups through annual check-ups, and the best possible long-term outcome.
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- A Phase 2 Multicenter Study of Axicabtagene Ciloleucel in Subjects With Relapsed/Refractory Indolent Non-Hodgkin Lymphoma (ZUMA-5)
- Check Point Inhibition After Autologous Stem Cell Transplantation in Patients at High Risk of Post Transplant Recurrence (CPIT001)
- Autologous CD8+ T-cells Expressing an Anti-BCMA CAR in Patients With Myeloma
Awards & Recognitions
MedStar Georgetown Awarded FACT Accreditation
Our program, home to the nation’s largest stem cell collection facility, is the region’s only adult, Foundation for the Accreditation of Cellular Therapy (FACT)-accredited program for autologous transplant, allogeneic transplant, and cellular immunotherapy.