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Is there a risk of Graft-Versus-Host Disease After Cord Blood Transplantation?

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Prapti Chauhan
Is there a risk of Graft-Versus-Host Disease After Cord Blood Transplantation?

Graft-versus-host disease (GVHD) is less common after umbilical cord blood transplantation compared to bone marrow transplantation. GVHD can range from mild to life-threatening. These days, doctors choose umbilical cord blood stem cells transplant over bone marrow to minimize the risk of GVH disease. Cord blood banking can help transplant patients get access to their umbilical cord blood stem cells. 

What is Graft-versus-host Disease?

Graft-versus-host disease (GVHD) is a condition that results from abnormal activities of the body’s immune system. GVHD is often considered an immune-mediated condition. It occurs due to the complex relations between donor and recipient adaptive immunity.

When the donor’s T cells or graft consider the patient’s healthy cells (the host) as foreign and attack and damage them, it is known as Graft-versus-host disease (GVHD). GVHD can affect a single area or multiple organs of the body. It can be mild or severe, and acute and chronic. Some GVHD can also be life-threatening.

Acute GVHD causes acute dermatitis, hepatitis, and enteritis within three months or 100 days of transplantation. Chronic GVHD includes more diverse symptoms that occur after 100 days of transplantation.

Symptoms of Acute GVHD

  • A skin rash with burning and itching
  • Blisters that may erupt
  • Flaky skin
  • Nausea
  • Vomiting
  • Abdominal cramp
  • Loss of appetite
  • Diarrhoea
  • Jaundice

Acute GVHD usually occurs within the first 100 days of transplant.

Symptoms of Chronic GVHD

  • Dry mouth
  • Mouth sensitivity
  • Mouth ulcers
  • Skin rash
  • Itchy skin
  • Change in skin colour
  • Brittle nails
  • Nail loss
  • Hair loss
  • Premature grey hair
  • Loss of body hair
  • Loss of appetite
  • Weight loss
  • Nausea
  • Diarrhoea
  • Vomiting
  • Abdominal pain
  • Jaundice
  • Shortness of breath
  • Wheezing
  • Persistent coughing
  • Muscle cramps
  • Stiffness of the joints
  • Vaginal dryness and itching

Why is Cord Blood Transplantation better than Bone Marrow Transplantation?

Cord blood transplants use blood cells from the umbilical cord blood. Newborn cord blood banking can help in newborn baby stem cell storage. The umbilical cord blood is collected at birth and preserved in cryogenic storage facilities in cord blood banks. During transplantation, these frozen blood cells are transplanted into the patient’s body through an intravenous catheter. The cells then move to the damaged tissues and help form healthy tissues or replace damaged tissues with healthy ones that grow into new tissues. Research proves that patients who get cord blood transplants get fewer cases of chronic GVHD. Patients who receive the anti-thymocyte globulin (ATG) medicine before a transplant get fewer cases of acute GVHD.

A mild case of GVHD is a good sign. It indicates that they are fighting any leftover malignant cells. Patients with mild symptoms of chronic GVHD, particularly when the GVHD is restricted to one organ, can be treated with symptomatic topical therapies. Mild cases of skin GVHD can be treated with steroid ointment. Similarly, mild cases of eye GVHD can be treated with steroid eye drops. However, you should not ignore serious cases of GVHD and treat them immediately.

Image source: https://www.nytimes.com/

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