GVHD.pptx

a presentation on GVHD

1. HOST VERSUS GRAFT DISEASE Ms. Revathy A SGNC

2. Introduction GVHD is a serious complication that may occur after allogenic stem cell transplantation. During the allogeneic transplantation, a person receives stem cells from a donor or from donated umbilical lord blood. When donor cells (the graft) attack the tissue and the cells of the patient (the host),the condition is known as “ Graft Versus Host Disease” (GVHD) .

3. Types/ Classification.

4. Each type affects different organs and tissues and has different signs and symptoms. Patient may develop one type or both types, or may not develop either type.

5. @ Acute GVHD Acute GVHD is a significant cause of medical problem and death following an allogenic stem cell transplantation. The frequency varies among populations. Depending on the donor type, transplant technique, and other features, b/w 30-70% of transplant recipients develop Acute GVHD. Acute GVHD primarily affects the skin, the liver and the Gl tract.

6. Risk factors HLA mismatch or unrelated donor. Older age of recipient or donor or both. Gender disparity. ( female to male pts) Severe regime- related toxicity. Use of T cell-replete graft. CMV- Seropositivity .

7. Symptoms... Skin Rashs – most common -starts as faint rash that may appear anywhere – Palms of hand I sole of feet - looks like a mild sunburn – irritable - more severe rashes features blistering and Peeling of skin. GI tract disorders- diarrhea due to inflammation of colon abdominal pain, bleeding, nausea & vomiting 🤢

8. Liver symptoms – commonly asymptomatic ,only can identify only through blood test -jaundice, bleeding, confusion, ascites

9. @ Chronic GVHD Chronic GVHD is a syndrome that may involve a single organ or several organs. It is one of the leading cause of medical problems and death after allogenic in stem cell transplantation. Approximately 30-70% persons develop chronic GVHD after allogeneic transplantation. It can lasts for months to year or even a lifetime.

10. Risk Factors... HLA mismatch Advanced age of patient, donor or both. Gender disparity No of parity of female donor. Stem cell source- Peripheral blood > bone marrow > cord blood Prior acute GVHD

11. Manifestations… Symptoms range from mild to life-threatening. Among the most commonly affected parts of the body are the skin, mouth, eyes, liver, Gl tract, lungs and joints.

12. The National Institute of Health (NIH) consensus criteria has classified GVHD based as the timing of presentation and the signs present. They are the following ;

13. # Classic Acute GVHD :- Signs of the disease occur within 100 days of stem cell transplantation. Display signs of acute GVHD. # Persistent, recurrent or late onset Acute GVHD:- Symptoms present more than 100 days after the transplant Features of acute GVHD.

14. # Classic Chronic GVHD: - May present at any time after transplantation. Distinctive features of chronic GVHD are present # Overlap Syndrome:- May present at any time after transplantation. Features of both acute and chronic GVHD are present.

15. Pathophysiology...

16. Diagnosis Patients with signs & symptoms of acute GVHD may need to have tests to confirm the diagnosis & rule out other conditions like drug reaction or infection.

17. Treatment Corticosteroid Administrations Ruxolitinib Ibrutinib – for chronic GVHD Mycophenolate mofetil Sirolimus Immunosuppressant Radiation of blood products before administration