Graft vs. Host Disease

Sam again. Day +39

Unfortunately, since leaving the hospital, Graham's nausea and vomiting persisted and his skin also developed a rash.

It looked like he was suffering from Graft vs. Host Disease (GVHD), which is when the new stem cells attack fast growing cells in his body such as the skin and gut.

This is not unexpected and a degree of GVHD is actually wanted as it also means that there is some Graft vs. Leukaemia (GVL) going on which can eliminate any undetectable leukaemia cells that may contribute to a relapse further down the track.

As you can see from the diagram above any unrelated transplants (such as Graham's Cord Blood Transplant) have a higher risk of GVHD but a reduced risk of relapse so the Doctors have a fine line to walk when treating the disease as they want to eliminate the GVHD and allow a degree of GVL.

They did a Skin Biopsy and a Gastroscopy with Biopsy last week and the GVHD has been confirmed.

He was re-admitted to the hospital on Friday to start back on the IV Nutrition as he has lost a lot of weight and has been unable to eat and they started Steroid Treatment for the GVHD yesterday and he should be feeling better soon. Once the GVHD is under control, they will taper off the steroids and watch for any flare ups.

It is disappointing to have this setback and the whole process is much more difficult than either of us had imagined but he is heading in the right direction and I am sure he will be back with you soon.