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Types
Symptoms
Causes
Diagnosis
Treatment
Prognosis
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Next in Graft-Versus-Host Disease Guide
Graft-versus-host disease (GvHD) is a complication of astem cellorbone marrow transplantin which the recipient’s tissues reject donor cells and launch an immune attack. This can lead to a range of mild to severe symptoms, based on which organs are attacked. A 2023 study of 3,542 people found that 40% experienced a GvHD diagnosis after transplant.
This article explains GvHD causes and symptoms of the condition. It discusses who may be more at risk of GvHD and how the condition is treated and prevented.
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Acute vs. Chronic Graft-Versus-Host Disease
Bone marrow or stem cell transplants are sometimes used in people withleukemiaandlymphomaas well as certain solid tumor cancers and blood-related disorders.GvHD is a complication associated withallogeneictransplants (in which cells are donated) rather thanautologous transplants(in which the donor and recipient are the same).
GvHD doesn’t always present in a consistent manner. It can sometimes manifest with features of acute and chronic GvHD, referred to as “overlap syndrome.” If acute symptoms develop after 100 days, the condition is often referred to as persistent, recurrent, late-onset acute GVHD.
Acute GvHD Risk FactorsOlder donor or recipient ageBeing whiteA female donor with a previous pregnancyHaving undergone total body irradiation (a method used to prevent the body from rejecting the transplanted cells)Chronic GvHD Risk FactorsOlder recipient ageHaving had acute GvHDPairing a female donor with a male recipientHaving undergone a stem cell transplant with a mobilizing agent (used to encourage stem cells to migrate to bone marrow)
Acute GvHD Risk FactorsOlder donor or recipient ageBeing whiteA female donor with a previous pregnancyHaving undergone total body irradiation (a method used to prevent the body from rejecting the transplanted cells)
Older donor or recipient age
Being white
A female donor with a previous pregnancy
Having undergone total body irradiation (a method used to prevent the body from rejecting the transplanted cells)
Chronic GvHD Risk FactorsOlder recipient ageHaving had acute GvHDPairing a female donor with a male recipientHaving undergone a stem cell transplant with a mobilizing agent (used to encourage stem cells to migrate to bone marrow)
Older recipient age
Having had acute GvHD
Pairing a female donor with a male recipient
Having undergone a stem cell transplant with a mobilizing agent (used to encourage stem cells to migrate to bone marrow)
Graft-Versus-Host Disease Symptoms
For instance, people who develop eye problems with chronic GvHD will almost invariable have a poorer prognosis than those who don’t.Similarly, people who develop orallichen planus, an inflammatory condition frequently seen in people with chronic GvHD, are at an increased risk of aggressiveoral cancersand early death.
Causes of Graft-Versus-Host Disease
These genes, referred to as major histocompatibility complex (MHC), are responsible for encoding surface proteins on cells known as human leukocyte antigen (HLA). HLA, in turn, helps the body differentiate between cells that are “normal” and those that are “foreign.”
Any cell considered foreign will trigger animmune response, releasing an army of white blood cells, calledT-cells, that target and neutralize the perceived invader.
With allogeneic transplants, donor cells will sometimes fail to recognize the recipient’s tissues as normal due to minute variations in the HLA structure. If this occurs, the donor cells can turn the body’s defenses on itself, leading to the onset of GvHD.
To reduce the risk of GvHD, specialists known ashematologist-oncologistswill turn to family members to be donors as they are more likely to be genetically matched.
If no matches are available, unrelated donors are used on the basis ofHLA blood test results. But even with a genetic match, the risk of GvHD remains high.
Research suggests that between 40% and 50% of people receiving a transplant from an HLA-matched sibling will develop acute GvHD, while 30% to 70% will develop chronic GvHD. The rate is even higher when an unrelated HLA-matched donor is involved.
Beyond HLA typing, there are other factors that can increase the risk of acute or chronic GvHD.
How Is GVHD Diagnosed?
Examples of confirmatory tests include:
The healthcare provider would also take into account the timing of the symptoms and perform adifferential diagnosisto exclude all other possible causes for the symptoms.
The NIH allows for some leeway in the diagnosis of acute GvHD if a classic rash, abdominal cramps with diarrhea, and increased bilirubin levels occur within the first 100 days of a transplant. In such cases, symptoms alone are enough to render a diagnosis.
Grading
Once GvHD has been diagnosed, the healthcare provider will grade the condition to characterize its severity, direct the appropriate course of treatment, and offer a prognosis.
Acute GvHD
There are several classifications systems used to grade acute GvHD, but among the most popular is the International Bone Marrow Transplant Registry (IBMTR) grading system.
The IBMTR system grades the severity of acute GvHD based on the degree of involvement of the skin, liver, and gastrointestinal tract. The system is graded from A through D, with A being the mildest form and D being the most severe.
Chronic GvHD
These scores are then used individually, rather than cumulatively, to grade chronic GvHD as either mild, moderate, or severe. Mild GvHD is often referred to as low-grade disease, while moderate to severe GvHD are considered moderate- and high-grade disease, respectively.
Differential Diagnoses
Although some symptoms of GvHD are “classic,” many others are non-specific and may have nothing with GvHD. To this end, healthcare providers will explore other explanations for the symptoms to ensure the correct diagnosis. These may include:
What Constitutes a Successful Stem Cell Transplant?
Graft-Versus-Host Disease Treatment
Corticosteroids
Mild cutaneous GvHD may only require atopical steroidto control skin symptoms. Options range from low-potency 1% hydrocortisone cream to high-potency 0.05%clobetasol propionateointment.PUVA phototherapyand Protopic (topical tacrolimus) may be added to the treatment plan for moderate to severe cases.
Severe symptoms in people with GvHD are typically treated with intravenous corticosteroids likeprednisoneand methylprednisone.
While effective at quickly relieving acute GvHD symptoms, high-dose steroids can increase the risk of bacterial, fungal, and viral infections as well as the likelihood of cancer recurrence.
To avoid this, thesteroid dose is gradually taperedover the course of months once the condition has been brought under control. Some people may require no further treatment. Others may require long-term topical, oral, or IV steroids to manage their condition, either alone or in combination with other therapies.
Other Immunosuppressants
In addition to steroids, there is an increasing number of nonsteroidal immune suppressants used to control GvHD, especially when thelong-term harms of corticosteroid useoutweigh the benefits. These include:
Even if symptoms aren’t entirely resolved, there are some benefits to having mild GvHD. Among other things, the abnormal activation of T-cells can kill any remaining cancer cells—referred to as the graft-versus-tumor (GVT) effect—while reducing the risk of cancer recurrence.
Maintaining the balance between GVT and GvHD can be tricky but, with consistent care from a skilled oncologist, the right therapy can be found and fine-tuned to achieve control.
What Is the Survival Rate for GvHD?
A number of factors affect graft-versus-host disease outcomes and life expectancy. One study that looked at 1,604 people following blood-related cancer treatment found GvHD was the primary cause of death among the 25% of people who developed it early (28 days or less).
People who develop GvHD but respond to corticosteroids have an overall five-year survival rate that’s around 50% (meaning that half of all people with GvHD will live for at least five years). Of those who do respond to corticosteroid therapy, anywhere from 20% to 25% will relapse.
Having acute GvHD is the predominant risk factor for the development of chronic GvHD and almost invariably leads to worse outcomes when it does.
Chronic GvHD is not only associated with debilitating illness in roughly a third of all cases but is also the leading cause of death non-relapse death, usually as the result of an infection.
Living With GvHD
There is no way to predict who will get GvHD, how well they will respond to treatment if they do, or whether or not they will relapse. The uncertainty can cause a great deal of stress, adding to the challenges that a transplant recipient already faces.
To better cope, you need to address symptoms of fatigue and weight loss that can complicate recovery as well as dealing with common skin and respiratory problems. Among the self-help tips:
Exercise
Gentle exercise can improve joint flexibility andrange of motion, increase lean muscle mass, and help overcome persistent fatigue. Incorporating gentle aerobics in your exercise plans, such a brisk walk, can improve respiratory function while stimulating the release of the “feel-good” hormones called endorphins.
Skin Care
Regular moisturizing is key to improving the tightness and dryness of the skin. Use anemollient-rich moisturizerwithout perfumes or fragrance, applied immediately after showering and throughout the day as needed.
Wear loose breathable fabrics like cotton to avoid heat build-up, which can trigger skininflammation, and always wear sunscreen with a minimumSPF 15when outdoors.
Diet
GvHD occurring in the gastrointestinal tract can cause significant diarrhea and weight loss. It often helps to embark on aBRAT diet(an acronym for bananas, rice, apple, and toast) to deal with acute diarrhea.
Sex
GvHD can sometimes affect the genitals and libido of both women and men. Estrogen cream (used two to three times weekly) may be prescribed to help soften vaginal tissues, while vaginal dilators can be used on a regular basis to avoid or reduce vaginal stenosis.
Testosterone replacement therapycan often help improve libido in men. Medical treatment under the care of aurologistor reconstructive surgeon may be needed to treat severe urethral stricture or vaginal stenosis.
Stress Management
Other stress management techniques include meditation, progressive muscle relaxation (PMR), and guided imagery.
It is also important to seek support from friends, family members, and support groups to better deal with the challenges of living with a transplant, whether you have GvHD or not.
Transplant Support Groups
Summary
Graft-versus-host disease (GvHD) is a common diagnosis following certain stem cell and tissue transplant procedures. Symptoms typically begin in the skin but spread across the body and into other organs. GvHD is a serious and often fatal development.
Treatment is possible, however, and GvHD symptoms can be effectively controlled medications. While some people require lifelong treatment, a great many don’t. Lifestyle changes and ongoing medical care can limit the impact of GvHD symptoms and improve your overall quality of life.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Akahoshi Y, Spyrou N, Hogan WJ, Ayuk F, DeFilipp Z, Weber D,et al.Incidence, clinical presentation, risk factors, outcomes, and biomarkers in de novo late acute GVHD.Blood Adv. 2023 Aug 22;7(16):4479-4491. doi: 10.1182/bloodadvances.2023009885Majhail NS, Farnia SH, Carpenter PA, et al.Indications for autologous and allogeneic hematopoietic cell transplantation: Guidelines from the American Society for Blood and Marrow Transplantation.Biol Blood Marrow Transplant. 2015;21(11):1863-9. doi:10.1016/j.bbmt.2015.07.032Zeiser R, Blazar BR.Acute graft-versus-host disease - biologic process, prevention, and therapy.N Engl J Med. 2017;377(22):2167-79. doi:10.1056/NEJMra1609337Sun YC, Chai X, Inamoto Y, et al.Impact of ocular chronic graft-versus-host disease on quality of life.Biol Blood Marrow Transplant. 2015;21(9):1687-91. doi:10.1016/j.bbmt.2015.05.020Tsukada S, Itonaga H, Taguchi J, Miyoshi T, Hayashida S, Sato S, et al.Gingival squamous cell carcinoma diagnosed on the occasion of osteonecrosis of the jaw in a patient with chronic GVHD.Rinsho Ketsueki.2019;60(1):22-7. 27. doi:10.11406/rinketsu.60.22Lazaryan A, Weisdorf DJ, Defor T, et al.Risk factors for acute and chronic graft-versus-host disease after allogeneic hematopoietic cell transplantation with umbilical cord blood and matched sibling donors.Biol Blood Marrow Transplant. 2016;22(1):134-40. doi:10.1016/j.bbmt.2015.09.008Jagasia MH, Greinix HT, Arora M, et al.National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and Staging Working Group report.Biol Blood Marrow Transplant.2015;21(3):389-401.e1. doi:10.1016/j.bbmt.2014.12.001Lee SJ.Classification systems for chronic graft-versus-host disease.Blood. 2017;129(1):30-7. doi:10.1182/blood-2016-07-686642Wolfe D, Lawitschka A.Chapter 44: Chronic graft-versus-host disease. In: The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies [Internet]. 7th edition.American Cancer Society.Stem cell or bone marrow transplant side effects.Lee SJ, Nguyen TD, Onstad L, et al.Success of immunosuppressive treatments in patients with chronic graft-versus-host disease.Biol Blood Marrow Transplant.2018;24(3):555-62. doi:10.1016/j.bbmt.2017.10.042Falkenburg JHF, Jedema I.Graft versus tumor effects and why people relapse.Hematology Am Soc Hematol Educ Program. 2017;2017(1):693-698. doi:10.1182/asheducation-2017.1.693Aziz MD, Shah J, Kapoor U, Dimopoulos C, Anand S, Augustine A,et al.Disease risk and GVHD biomarkers can stratify patients for risk of relapse and nonrelapse mortality post hematopoietic cell transplant.Leukemia. 2020 Jul;34(7):1898-1906. doi: 10.1038/s41375-020-0726-z.Kato M, Kurata M, Kanda J, et al.Impact of graft-versus-host disease on relapse and survival after allogeneic stem cell transplantation for pediatric leukemia.Bone marrow Transplant. 2019 Jan;54(1):68-75. doi:10.1038/s41409-018-0221-6Cancer Research UK.Treatment for chronic GvHD.Noerskov KH, Schjødt I, Syrjala KL, Jarden M.Sexual function 1-year after allogeneic hematopoietic stem cell transplantation.Bone Marrow Transplant. 2016;51(6):833-40. doi:10.1038/bmt.2015.342
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Akahoshi Y, Spyrou N, Hogan WJ, Ayuk F, DeFilipp Z, Weber D,et al.Incidence, clinical presentation, risk factors, outcomes, and biomarkers in de novo late acute GVHD.Blood Adv. 2023 Aug 22;7(16):4479-4491. doi: 10.1182/bloodadvances.2023009885Majhail NS, Farnia SH, Carpenter PA, et al.Indications for autologous and allogeneic hematopoietic cell transplantation: Guidelines from the American Society for Blood and Marrow Transplantation.Biol Blood Marrow Transplant. 2015;21(11):1863-9. doi:10.1016/j.bbmt.2015.07.032Zeiser R, Blazar BR.Acute graft-versus-host disease - biologic process, prevention, and therapy.N Engl J Med. 2017;377(22):2167-79. doi:10.1056/NEJMra1609337Sun YC, Chai X, Inamoto Y, et al.Impact of ocular chronic graft-versus-host disease on quality of life.Biol Blood Marrow Transplant. 2015;21(9):1687-91. doi:10.1016/j.bbmt.2015.05.020Tsukada S, Itonaga H, Taguchi J, Miyoshi T, Hayashida S, Sato S, et al.Gingival squamous cell carcinoma diagnosed on the occasion of osteonecrosis of the jaw in a patient with chronic GVHD.Rinsho Ketsueki.2019;60(1):22-7. 27. doi:10.11406/rinketsu.60.22Lazaryan A, Weisdorf DJ, Defor T, et al.Risk factors for acute and chronic graft-versus-host disease after allogeneic hematopoietic cell transplantation with umbilical cord blood and matched sibling donors.Biol Blood Marrow Transplant. 2016;22(1):134-40. doi:10.1016/j.bbmt.2015.09.008Jagasia MH, Greinix HT, Arora M, et al.National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and Staging Working Group report.Biol Blood Marrow Transplant.2015;21(3):389-401.e1. doi:10.1016/j.bbmt.2014.12.001Lee SJ.Classification systems for chronic graft-versus-host disease.Blood. 2017;129(1):30-7. doi:10.1182/blood-2016-07-686642Wolfe D, Lawitschka A.Chapter 44: Chronic graft-versus-host disease. In: The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies [Internet]. 7th edition.American Cancer Society.Stem cell or bone marrow transplant side effects.Lee SJ, Nguyen TD, Onstad L, et al.Success of immunosuppressive treatments in patients with chronic graft-versus-host disease.Biol Blood Marrow Transplant.2018;24(3):555-62. doi:10.1016/j.bbmt.2017.10.042Falkenburg JHF, Jedema I.Graft versus tumor effects and why people relapse.Hematology Am Soc Hematol Educ Program. 2017;2017(1):693-698. doi:10.1182/asheducation-2017.1.693Aziz MD, Shah J, Kapoor U, Dimopoulos C, Anand S, Augustine A,et al.Disease risk and GVHD biomarkers can stratify patients for risk of relapse and nonrelapse mortality post hematopoietic cell transplant.Leukemia. 2020 Jul;34(7):1898-1906. doi: 10.1038/s41375-020-0726-z.Kato M, Kurata M, Kanda J, et al.Impact of graft-versus-host disease on relapse and survival after allogeneic stem cell transplantation for pediatric leukemia.Bone marrow Transplant. 2019 Jan;54(1):68-75. doi:10.1038/s41409-018-0221-6Cancer Research UK.Treatment for chronic GvHD.Noerskov KH, Schjødt I, Syrjala KL, Jarden M.Sexual function 1-year after allogeneic hematopoietic stem cell transplantation.Bone Marrow Transplant. 2016;51(6):833-40. doi:10.1038/bmt.2015.342
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Akahoshi Y, Spyrou N, Hogan WJ, Ayuk F, DeFilipp Z, Weber D,et al.Incidence, clinical presentation, risk factors, outcomes, and biomarkers in de novo late acute GVHD.Blood Adv. 2023 Aug 22;7(16):4479-4491. doi: 10.1182/bloodadvances.2023009885Majhail NS, Farnia SH, Carpenter PA, et al.Indications for autologous and allogeneic hematopoietic cell transplantation: Guidelines from the American Society for Blood and Marrow Transplantation.Biol Blood Marrow Transplant. 2015;21(11):1863-9. doi:10.1016/j.bbmt.2015.07.032Zeiser R, Blazar BR.Acute graft-versus-host disease - biologic process, prevention, and therapy.N Engl J Med. 2017;377(22):2167-79. doi:10.1056/NEJMra1609337Sun YC, Chai X, Inamoto Y, et al.Impact of ocular chronic graft-versus-host disease on quality of life.Biol Blood Marrow Transplant. 2015;21(9):1687-91. doi:10.1016/j.bbmt.2015.05.020Tsukada S, Itonaga H, Taguchi J, Miyoshi T, Hayashida S, Sato S, et al.Gingival squamous cell carcinoma diagnosed on the occasion of osteonecrosis of the jaw in a patient with chronic GVHD.Rinsho Ketsueki.2019;60(1):22-7. 27. doi:10.11406/rinketsu.60.22Lazaryan A, Weisdorf DJ, Defor T, et al.Risk factors for acute and chronic graft-versus-host disease after allogeneic hematopoietic cell transplantation with umbilical cord blood and matched sibling donors.Biol Blood Marrow Transplant. 2016;22(1):134-40. doi:10.1016/j.bbmt.2015.09.008Jagasia MH, Greinix HT, Arora M, et al.National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and Staging Working Group report.Biol Blood Marrow Transplant.2015;21(3):389-401.e1. doi:10.1016/j.bbmt.2014.12.001Lee SJ.Classification systems for chronic graft-versus-host disease.Blood. 2017;129(1):30-7. doi:10.1182/blood-2016-07-686642Wolfe D, Lawitschka A.Chapter 44: Chronic graft-versus-host disease. In: The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies [Internet]. 7th edition.American Cancer Society.Stem cell or bone marrow transplant side effects.Lee SJ, Nguyen TD, Onstad L, et al.Success of immunosuppressive treatments in patients with chronic graft-versus-host disease.Biol Blood Marrow Transplant.2018;24(3):555-62. doi:10.1016/j.bbmt.2017.10.042Falkenburg JHF, Jedema I.Graft versus tumor effects and why people relapse.Hematology Am Soc Hematol Educ Program. 2017;2017(1):693-698. doi:10.1182/asheducation-2017.1.693Aziz MD, Shah J, Kapoor U, Dimopoulos C, Anand S, Augustine A,et al.Disease risk and GVHD biomarkers can stratify patients for risk of relapse and nonrelapse mortality post hematopoietic cell transplant.Leukemia. 2020 Jul;34(7):1898-1906. doi: 10.1038/s41375-020-0726-z.Kato M, Kurata M, Kanda J, et al.Impact of graft-versus-host disease on relapse and survival after allogeneic stem cell transplantation for pediatric leukemia.Bone marrow Transplant. 2019 Jan;54(1):68-75. doi:10.1038/s41409-018-0221-6Cancer Research UK.Treatment for chronic GvHD.Noerskov KH, Schjødt I, Syrjala KL, Jarden M.Sexual function 1-year after allogeneic hematopoietic stem cell transplantation.Bone Marrow Transplant. 2016;51(6):833-40. doi:10.1038/bmt.2015.342
Akahoshi Y, Spyrou N, Hogan WJ, Ayuk F, DeFilipp Z, Weber D,et al.Incidence, clinical presentation, risk factors, outcomes, and biomarkers in de novo late acute GVHD.Blood Adv. 2023 Aug 22;7(16):4479-4491. doi: 10.1182/bloodadvances.2023009885
Majhail NS, Farnia SH, Carpenter PA, et al.Indications for autologous and allogeneic hematopoietic cell transplantation: Guidelines from the American Society for Blood and Marrow Transplantation.Biol Blood Marrow Transplant. 2015;21(11):1863-9. doi:10.1016/j.bbmt.2015.07.032
Zeiser R, Blazar BR.Acute graft-versus-host disease - biologic process, prevention, and therapy.N Engl J Med. 2017;377(22):2167-79. doi:10.1056/NEJMra1609337
Sun YC, Chai X, Inamoto Y, et al.Impact of ocular chronic graft-versus-host disease on quality of life.Biol Blood Marrow Transplant. 2015;21(9):1687-91. doi:10.1016/j.bbmt.2015.05.020
Tsukada S, Itonaga H, Taguchi J, Miyoshi T, Hayashida S, Sato S, et al.Gingival squamous cell carcinoma diagnosed on the occasion of osteonecrosis of the jaw in a patient with chronic GVHD.Rinsho Ketsueki.2019;60(1):22-7. 27. doi:10.11406/rinketsu.60.22
Lazaryan A, Weisdorf DJ, Defor T, et al.Risk factors for acute and chronic graft-versus-host disease after allogeneic hematopoietic cell transplantation with umbilical cord blood and matched sibling donors.Biol Blood Marrow Transplant. 2016;22(1):134-40. doi:10.1016/j.bbmt.2015.09.008
Jagasia MH, Greinix HT, Arora M, et al.National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and Staging Working Group report.Biol Blood Marrow Transplant.2015;21(3):389-401.e1. doi:10.1016/j.bbmt.2014.12.001
Lee SJ.Classification systems for chronic graft-versus-host disease.Blood. 2017;129(1):30-7. doi:10.1182/blood-2016-07-686642
Wolfe D, Lawitschka A.Chapter 44: Chronic graft-versus-host disease. In: The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies [Internet]. 7th edition.
American Cancer Society.Stem cell or bone marrow transplant side effects.
Lee SJ, Nguyen TD, Onstad L, et al.Success of immunosuppressive treatments in patients with chronic graft-versus-host disease.Biol Blood Marrow Transplant.2018;24(3):555-62. doi:10.1016/j.bbmt.2017.10.042
Falkenburg JHF, Jedema I.Graft versus tumor effects and why people relapse.Hematology Am Soc Hematol Educ Program. 2017;2017(1):693-698. doi:10.1182/asheducation-2017.1.693
Aziz MD, Shah J, Kapoor U, Dimopoulos C, Anand S, Augustine A,et al.Disease risk and GVHD biomarkers can stratify patients for risk of relapse and nonrelapse mortality post hematopoietic cell transplant.Leukemia. 2020 Jul;34(7):1898-1906. doi: 10.1038/s41375-020-0726-z.
Kato M, Kurata M, Kanda J, et al.Impact of graft-versus-host disease on relapse and survival after allogeneic stem cell transplantation for pediatric leukemia.Bone marrow Transplant. 2019 Jan;54(1):68-75. doi:10.1038/s41409-018-0221-6
Cancer Research UK.Treatment for chronic GvHD.
Noerskov KH, Schjødt I, Syrjala KL, Jarden M.Sexual function 1-year after allogeneic hematopoietic stem cell transplantation.Bone Marrow Transplant. 2016;51(6):833-40. doi:10.1038/bmt.2015.342
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What Is Graft-Versus-Host Disease?Causes and Risk Factors of Graft-Versus-Host DiseaseHow Graft-Versus-Host Disease (GvHD) Is DiagnosedHow Graft-Versus-Host Disease (GvHD) Is TreatedCoping With Graft-Versus-Host-Disease
What Is Graft-Versus-Host Disease?
Causes and Risk Factors of Graft-Versus-Host Disease
How Graft-Versus-Host Disease (GvHD) Is Diagnosed
How Graft-Versus-Host Disease (GvHD) Is Treated
Coping With Graft-Versus-Host-Disease
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