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Guilherme Mazui

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What is the Difference Between Acute and Chronic GVHD?

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Acute and chronic graft-versus-host disease (GVHD) are both complications of allogeneic hematopoietic cell transplants, but they differ in several aspects:

Acute GVHD:

  • Usually manifests within 100 days following transplant.
  • Induced by donor T cells responding to mismatched host polymorphic histocompatibility antigens.
  • Mainly affects the skin, gut (including the bowel and stomach), and liver.
  • Symptoms can range from mild to severe.

Chronic GVHD:

  • Generally manifests later (>100 days) following transplant.
  • Has some features of autoimmune diseases and may develop either de novo or following resolution of, or as an extension of, acute GVHD.
  • Can affect multiple organs, including those not affected by acute GVHD, such as the mouth, eyes, lungs, genitals, and joints.
  • More debilitating over a long time and may require long-term treatment.

Both acute and chronic GVHD are assessed and graded based on the number of organs affected and the severity of the condition. Treatment options depend on the grade and type of GVHD, with acute GVHD often requiring immunosuppressive medications and chronic GVHD sometimes needing more involved therapies like steroids, photopheresis, or other medications.

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  • What is the Difference Between Acute and Chronic GVHD?
  • Comparative Table: Acute vs Chronic GVHD

    • Comparative Table: Acute vs Chronic GVHD

    Acute and chronic graft-versus-host disease (GVHD) are multisystem disorders that are common complications of allogeneic hematopoietic cell transplantation. Here is a table highlighting the differences between acute and chronic GVHD:

    Feature Acute GVHD Chronic GVHD
    Onset Symptoms typically appear within the first 100 days after transplantation. However, some cases may occur later. Symptoms typically appear after 100 days post-transplantation, but there have been cases where it occurred before 100 days.
    Symptoms Primarily affects the skin, liver, and gastrointestinal (GI) tract. Other organs may also be involved, but with less severity. Affects multiple organs throughout the body, including the skin, liver, GI tract, lungs, joints, and eyes.
    Pathophysiology Thought to be driven by a cytokine-driven response. Believed to involve more autoimmune-type, fibrotic-type changes.
    Staging and Grading Staged and graded according to the extent of organ involvement, with grades ranging from 0 to IV. No specific staging or grading system, but the Global Oncology Learning Network (GOLN) criteria can be used to assess and monitor the severity of symptoms.
    Treatment Often treated by optimizing immunosuppression and adding corticosteroids, such as methylprednisolone. Treatment may involve a combination of immunosuppressants and other therapies, depending on the severity and specific symptoms.

    Please note that the difference between acute and chronic GVHD is not solely based on the timing of their onset, as some cases may not follow the traditional timing. Additionally, there may be an overlap period where a patient has symptoms of both acute and chronic GVHD.

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    Guilherme Mazui

    Guilherme Mazui is graduated in journalism from the Federal University of Minas Gerais (UFMG) and a master's degree in Communication from the University of São Paulo (USP). In addition, he has experience in advertising writing and has worked as a content editor in several companies.