Summary: Chronic graft-versus-host disease is a common complication after a transplant using donor cells (allogeneic transplant). Early detection and treatment are critical to successful management of the disease. Side effects from drugs used to treat chronic GVHD can increase the risk of health problems later in life.

July 13, 2020 Part of the Virtual Celebrating a Second Chance at Life Survivorship Symposium 2020
Presentation is 38 minutes with 21 minutes of Q&A.

Presenter: Corey Cutler MD, MPH, FRCPC, Medical Director, Adult Stem Cell Transplantation Program and Director, Stem Cell Transplantation Survivorship Program, Dana-Farber Cancer Institute. Meet Dr. Cutler: [ Ссылка ]

To view full transcript: [ Ссылка ]

Highlights:

- Graft-versus-Host disease (GVHD) affects approximately half of individuals who undergo a stem cell transplant using cells from a donor (allogeneic transplant).
- Skin, mouth, and eyes are the organs most frequently affected by chronic GVHD.
- It is important for stem cell transplant patients to know the risks and signs of GVHD and seek appropriate treatment.
- Physicians not familiar with GVHD may incorrectly diagnose a patient with a more common autoimmune disease.

July 13, 2020 Part of the Virtual Celebrating a Second Chance at Life Survivorship Symposium 2020
Presentation is 38 minutes with 21 minutes of Q&A.

Key Points:

02:27 GVHD occurs when the transplanted immune system, or the graft, attacks recipient tissues, or the host.

03:39 Historically acute and chronic GVHD were distinguished by the number of days the stem cell patient was after transplant. Today, acute and chronic GVHD are distinguished by organs involved and symptoms.

09:34 Chronic GVHD is often called the great mimicker because it mimics signs and symptoms of some autoimmune diseases.

10:12 Symptoms of chronic GVHD of the skin include changes in pigmentation, stiffness of the skin, nail changes, and changes to the hair and scalp.

10:37 Symptoms of chronic GVHD in the mouth include sensitivity, pain with temperature (hot or cold foods), and discomfort with spicy or acidic foods.

10:51 Symptoms of chronic GVHD in the eyes include inflammation, redness in the eyes, pain, itchy, and or the sensation of sand in eyes.

15:24 Diagnosis of chronic GVHD requires a comprehensive physical examination led by a transplant physician and eye examination by an ophthalmologist who understands chronic GVHD. The mouth can be examined either by the transplant physician or an oral medicine specialist.

18:47 Treatment options for chronic GVHD depend on whether the GVHD is localized to one organ or affects multiple organs.

21:30 The majority of stem cell transplant patients with chronic GVHD will need a second line therapy beyond steroids. It will require trial and error to find a personalized treatment that works for each individual patient.

33:04 Long-term side effects of steroids used to treat chronic GVHD after can include immune deficiency, cataracts, chronic kidney disease, diabetes , high cholesterol, reduced muscle strength, adrenal insufficiency; the adrenal glands, osteoporosis, nerve damage and poor wound healing.

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