Chronic GVHD is different than acute GVHD. It usually develops later than acute GVHD, typically five-to-six months after your transplant, and can affect more organs and tissues.
Chronic GVHD occurs most often in patients who:
- previously had acute GVHD
- are older
- were transplanted with cells from an unrelated donor or from a donor who was not a perfect match
- were transplanted with stem cells collected from the bloodstream rather than bone marrow or cord blood
- are a male and received cells from a female donor
- received cells from a female donor who previously bore children
Most cases of chronic GVHD are mild or moderate. However, some patients develop more severe symptoms.
Organs Affected
Chronic GVHD can affect only one organ but usually affects multiple organs and tissues at the same time. Chronic GVHD most often affects:
- skin and nails
- eyes
- mouth
- liver
Less frequently, chronic GVHD affects the:
- lungs
- intestines
- joints
- genitals
- muscles
- nervous system
Treatment
How your doctor manages your chronic GVHD depends on which organs and tissues are affected, the severity of the symptoms and how chronic GVHD is impacting your daily life.
If chronic GVHD is affecting only one or two organs or tissues, you doctor may choose a localized therapy, like a skin ointment, to manage your disease.
ow your doctor manages your chronic GVHD depends on which organs and tissues are affected, the severity of the symptoms, and the impact GVHD is having on your daily life.
If chronic GVHD affects only one or two organs or tissues, your doctor may choose a localized therapy, such as an ointment, mouthwash, or eye drops, to relieve symptoms.
If chronic GVHD is affecting many different parts of your body or if the symptoms are severe, your doctor may need to treat it with drugs that suppress your immune system, such as:
- prednisone
- prednisone with cyclosporine or tacrolimus
- sirolimus
If your chronic GVHD does not respond well to these treatments, your doctor may try other drugs or treatments, such as:
- ibrutinib
- ruxolitinib
- belumosudil
- axatilimab
- methotrexate
- mycophenolate mofetil
- sirolimus
- extracorporeal photopheresis
- low dose interleukin-2
- abatacept
Patients with chronic GVHD typically require treatment for three to five years. Approximately 15 percent of patients require treatment for a longer time period, and, in rare cases, some patients need life-long immunosuppressive drugs.
If you are diagnosed with chronic GVHD, it is important that you take your medication even when you start to feel better. Stopping your medication too early can cause your GVHD to flare up again or worsen.
Take Action!
Because chronic GVHD usually develops more than 100 days after transplant when you are no longer having weekly visits with the transplant team, it's important that you examine your body weekly for signs of GVHD.
Carefully inspect your mouth, eyes, skin, joints and genitals for any changes. Don’t ignore subtle changes. Report anything unusual to your doctor immediately.
Don’t be afraid to ask questions. If you notice a change, don’t assume it’s nothing to worry about. Ask your care team to be sure.
Watch this video about chronic GVHD. Click here to read the transcript.
(To view this page in Spanish click here)
Next Page: How Chronic GVHD affects Skin, Hair, Nails and Sweat Glands
Updated December 2024
