I personally needed to understand the science of acute graft vs. host disease for me to realize it is not that scary. I’m no expert but here is a little explanation of information that has helped me.
If you haven’t already heard from your doctors or nurses, after receiving an allogenic (bone marrow from another donor) bone marrow transplant you are subject to experiencing graft versus host disease. Remember that the purpose of the bone marrow transplant is so that the donor’s bone marrow “engrafts” to your body. Basically, the healthy cells from your donor will begin to multiply and produce healthy blood. You - the patient - are the host. However, there is a condition called Graft vs. Host disease that can occur if you received an allogeneic transplant. There are two different types of GVHD - acute and chronic. During GVHD, your donor’s immune response recognizes your body as foreign and therefore, “attacks” it. This can manifest in a few different ways. For example, you might see a rash break out on your skin or experience a fever. Some people experience nausea, diarrhea, vomiting, or mouth changes. At your weekly appointments, your team will also check your blood for any other changes.
When I first heard about GVHD, I was a little apprehensive. It sounded like a type disease that would significantly complicate everything. And I was fearful about it. However, my doctor reassured me that actually, a small amount of acute GVHD is good. How can this be? She explained that this indicates the strength of your donor’s immune response and the engraftment that took place. Doctors will actually refer to GVHD as “graft vs. leukemia” (donor cells vs. leukemia cells). As I mentioned, there are moments when your donor will attack other cells in your body - good and/or bad cells. It is important to understand that in healthy individuals, the immune system can destroy cancer cells. Pretty remarkable, right? The treatments you received (chemo and/or radiation) have contributed to killing off any cancer cells BUT your donor’s immune system has ALSO attacked and killed any cancer cells. Kind of amazing, right?
How is acute graft vs. host treated?
Acute GVHD is typically treated with a type of steroid. You're probably instantly thinking of steroids that body builders take but this is actually entirely different. Body builders will take “anabolic” steroids which build muscle. However, medical treatments use “catabolic” steroids. The purpose of these types of steroids is to reduce inflammation and suppress the immune system. While it does the job, it simultaneously breaks down different systems in your body. This breakdown comes in the form of many different side effects. I can only speak from my experience, so I will share how it has impacted my life in another post!
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