Can allogeneic stem cell transplant cause graft-versus-host disease?

It may begin soon after transplant or appear later. The skin, digestive tract and liver are commonly involved, but symptoms and severity vary from person to person.

An allogeneic transplant uses stem cells from a donor. The new immune system can recognise some of the recipient's healthy cells as foreign and react against them; this reaction is called graft-versus-host disease, or GVHD.

Acute and chronic GVHD can affect the body differently. Possible features include a new rash, persistent diarrhoea, abdominal pain, nausea, yellowing of the skin or eyes, dry mouth, dry or irritated eyes, joint stiffness and breathlessness. These symptoms can also have other causes after transplant, so the transplant team needs to assess them.

Take immune-suppressing medicines exactly as prescribed and do not stop or change a dose without guidance from the transplant team. Attend scheduled blood tests and follow-up visits, because examination and laboratory results may identify organ changes that are not obvious at home.

Track new symptoms, when they started and whether they are worsening. Protect treated skin, maintain mouth and eye care as advised, and follow the team's food-safety and infection-prevention instructions while immunity is reduced. Treatment may include adjusting immune suppression and adding therapy aimed at the affected organ.

Contact the transplant team promptly for a new or spreading rash, repeated watery diarrhoea, worsening abdominal pain, vomiting that prevents fluids or medicines staying down, yellow skin or eyes, dark urine, new mouth sores, increasing eye discomfort or an unexplained decline in energy.

Get urgent medical help for trouble breathing, severe weakness, confusion, fainting, heavy bleeding or an inability to keep fluids down. Use the emergency contact plan supplied by the transplant centre and tell any emergency clinician that you have had an allogeneic transplant.

Ask which changes should trigger a same-day call, how to reach the service outside clinic hours, and what to do if vomiting or diarrhoea interferes with your medicines. You can also ask how long monitoring will continue, which organs are being checked and what side effects to report from GVHD treatment.