The key difference between acute and chronic GVHD is that acute GVHD is any reaction that occurs within the first 100 days of allogeneic transplantation, while chronic GVHD is any reaction that occurs after 100 days of allogeneic transplantation.
Allogeneic stem cell transplantation is a type of transplantation that involves taking stem cells from someone other than the patient. Sometimes, allogeneic transplantation can trigger graft versus host disease (GVHD). GVHD occurs when particular types of white blood cells in the donated stem cells or bone marrow attack the own body cells of the patient. Acute and chronic GVHD are two types of graft versus host disease.
CONTENTS
1. Overview and Key Difference
2. What is Acute GVHD
3. What is Chronic GVHD
4. Similarities – Acute and Chronic GVHD
5. Acute vs. Chronic GVHD in Tabular Form
6. Summary – Acute vs. Chronic GVHD
What is Acute GVHD?
Acute GVHD is a type of graft versus host disease. It happens within 100 days after allogeneic transplantation. This type of graft versus host disease affects the immune system, skin, liver, and intestine. The common symptoms of acute GVHD may include abdominal cramps, nausea, vomiting, diarrhoea, jaundice, other liver problems, skin rashes, itching, redness in the areas of the skin, and an increased risk of infections.
Figure 01: Acute GVHD
Moreover, acute GVHD can be diagnosed through medical history, physical examination, X-ray and CT scan of the abdomen, liver function test, liver biopsy, and skin biopsy. Furthermore, the treatment options for Acute GVHD may include steroid therapy, drugs such as immunosuppressants to suppress your immune system and reduce the GVHD, and light therapy with extracorporeal photophoresis.
What is Chronic GVHD?
Chronic GVHD is a type of graft versus host disease. It happens after 100 days of allogeneic transplantation. Sometimes, it can last a lifetime. Chronic GVHD mainly affects organs such as skin, mouth, liver, eye, lung, GI tract, joint or fascia, and genital tract. Moreover, chronic GVHD symptoms may include dry eyes, burning sensation in the eye or vision changes, dry mouth, white patches in the mouth, sensitivity to spicy foods, muscle weakness and fatigue, joint pain and stiffness, raised skin rashes, discolored areas in the skin, skin tightening, shortness of breath, vaginal dryness, weight loss, reduced bile flow from the liver, brittle hair, premature hair greying, damages to sweat glands, cytopenia, and pericarditis.
Figure 02: Chronic GVHD
Moreover, chronic GVHD can be diagnosed through medical history, physical examination, and imaging tests such as an abdomen X-ray, CT scan of the abdomen and chest, PET scan, MRI, capsule endoscopy, joint scans, liver biopsy, skin biopsy, and eye examination. Furthermore, chronic GVHD can be treated through steroids therapy or ciclosporin to reduce your immune response, keeping the skin clean and moisturizing daily, keeping skin comfortable, a cream of tacrolimus for skin problems, antihistamines for itching, a particular type of light therapy called extracorporeal photopheresis (ECP), newer treatments such as halofuginone, etanercept, and hydroxychloroquine, cleaning your mouth regularly, mouthwashes, artificial saliva for mouth dryness, cleaning eyelids every day, and varenicline (Tyrvaya) for dry eyes.
What are the Similarities Between Acute and Chronic GVHD?
- Acute and chronic GVHD are two types of graft versus host diseases.
- Both are due to particular types of white blood cells in the donated stem cells or bone marrow attacking the own body cells of the patient.
- They can cause similar symptoms, such as skin problems, muscle weakness, fatigue, liver problems, etc.
- Both types can be diagnosed through medical history, physical examination, imaging tests, and liver tests.
- They are treated through steroid therapy, creams for skin problems, and light therapy with extracorporeal photophoresis.
What is the Difference Between Acute and Chronic GVHD?
Acute GVHD is any reaction that occurs within the first 100 days of allogeneic transplantation, while chronic GVHD is any reaction that occurs after 100 days of allogeneic transplantation. Thus, this is the key difference between acute and chronic GVHD. Furthermore, acute GVHD is less complicated than chronic GVHD, which has many complications.
The infographic below presents the differences between acute and chronic GVHD in tabular form for side-by-side comparison.
Summary – Acute vs Chronic GVHD
GVHD is a dangerous complication of an allogeneic transplant. In GVHD, the donated stem cells received during an allogeneic stem cell transplant detect the body’s own cells as a threat and then attack. GVHD is of mainly two types: acute and chronic GVHD. Acute GVHD happens within 100 days after allogeneic transplantation, while chronic Acute GVHD happens after 100 days. So, this is the key difference between acute and chronic GVHD.
Reference:
1. Jacobsohn, David A, and Georgia B Vogelsang. “Acute Graft versus Host Disease.” Orphanet Journal of Rare Diseases.
2. “Chronic Graft-versus-Host Disease.” BMT Infonet.
Image Courtesy:
1. “Mouse colon histology of acute graft versus host disease” By Gandh07 – (CC BY-SA 4.0) via Commons Wikimedia
2. “Micrographs of grades of skin graft-versus-host-disease” By Sakhila Ghimire, Daniela Weber, Emily Mavin, Xiao nong Wang, Anne Mary Dickinson, and Ernst Holler1 – (2017). “Pathophysiology of GvHD and Other HSCT-Related Major Complications.” Frontiers in Immunology 8. DOI:10.3389/fimmu.2017.00079. ISSN 1664-3224. (CC BY 4.0) via Commons Wikimedia