Chronic Graft-versus-Host Disease: Adverse Effects From Treatment

According to a video posted on Targeted Oncology, adverse events are a significant concern for people that are receiving treatment for the chronic form of graft-versus-host disease. In the video, Dr. Robert Zeiser, MD, of the Freiburg University Medical System in Germany, talks about what physicians need to do in order to monitor for adverse events and minimize the impacts that they may have.

About Graft-versus-Host Disease

Graft-versus-Host disease is a potentially fatal medical complication that can appear in a patient that has recently received a transplant operation from another person. It is most commonly triggered by bone marrow transplants but it can also occur with solid organ transplants as well. The disease occurs when white blood cells that remain in the transplanted tissue begin to identify the host body as a foreign intruder and begin to attack the host’s cells. Many recipients of transplanted tissue have weakened immune systems which means that their own body is often incapable of preventing the attack from beginning. Symptoms of graft-versus-host disease include skin rashes, gastrointestinal and liver damage, and damage to the mucosa. Long term disease may see the attack spread to other areas as well, such as the host immune system, the exocrine glands, lungs, and connective tissue. Treatment often includes immunosuppressants such as steroids and certain chemotherapy agents. To learn more about graft-versus-host disease, click here.

Avoiding Complications and Adverse Events

Dr. Zeiser makes it clear that the complications resulting from the treatment of this chronic disease can be severe; patients may develop diabetes, meaning that doctors have to monitor blood sugar levels closely. This also requires steroid treatment to be tapered quickly to minimize risk. The corticosteroid regimen can also put patients at risk for osteoporosis and osteonecrosis, and bone density is another factor that must be monitored when high doses of corticosteroids are used.

Proton pump inhibitors are also used in these patients in order to prevent the development of peptic ulcer disease. Other complications that patients face include food retention and high blood pressure. Some patients may require diuretics. Treatment can also increase the risk of infection, and prophylaxis for certain infections may be necessary. 

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