Signs of Graft-Versus-Host Disease After Leukemia Bone Marrow Transplantation

After undergoing a bone marrow transplant for leukemia, patients may experience various complications, the most significant being graft-versus-host disease (GVHD). This condition occurs when the newly transplanted immune cells recognize the recipient's body as foreign and launch an immune attack. GVHD is one of the most common post-transplant challenges and can affect multiple organs, leading to a range of symptoms that require prompt medical attention.

Common Symptoms of Post-Transplant Rejection

One of the earliest and most frequent signs of rejection is unexplained fever. This often appears before other physical symptoms and signals that the body is undergoing an immune response. Alongside fever, many patients develop skin rashes—ranging from mild redness to severe blistering—which typically appear on the palms, soles, or torso.

Liver involvement is another critical indicator. Patients may experience elevated liver enzymes, jaundice (yellowing of the skin or eyes), and dark urine due to impaired liver function. These signs suggest that the transplanted immune cells are attacking liver tissues, requiring immediate evaluation and treatment.

Gastrointestinal symptoms are also prevalent in moderate to severe cases. These include persistent nausea, vomiting, abdominal cramps, and chronic diarrhea—sometimes with blood. Such symptoms not only reduce quality of life but can also lead to dehydration and malnutrition if not managed effectively.

Understanding Leukemia and the Role of Stem Cell Transplants

Leukemia is a type of aggressive blood cancer characterized by the uncontrolled growth of abnormal white blood cells. It originates in the bone marrow, where faulty stem cells multiply and disrupt normal blood cell production. While chemotherapy remains a primary treatment to induce remission, allogeneic hematopoietic stem cell transplantation (HSCT) offers a potential cure—especially for high-risk or relapsed cases.

How Transplant Rejection Happens

During an allogeneic transplant, stem cells from a donor are infused into the patient's bloodstream to rebuild a healthy immune system. However, because these donor cells contain their own genetic identity, they may perceive the recipient's tissues as foreign. This mismatch triggers an immunological reaction known as graft-versus-host disease, which can be acute (occurring within 100 days post-transplant) or chronic (developing months later).

The severity of GVHD varies widely among individuals and depends on factors such as donor compatibility, age, pre-transplant conditioning regimens, and overall health status.

Managing Rejection: Key Treatment Strategies

Early detection and intervention are crucial in managing post-transplant complications. Physicians typically use immunosuppressive drugs—such as corticosteroids, tacrolimus, or cyclosporine—to dampen the overactive immune response and prevent further organ damage.

In cases involving liver dysfunction, supportive therapies including hepatoprotective agents may be administered to stabilize liver enzymes and improve metabolic function. Additionally, nutritional support and anti-nausea medications help alleviate gastrointestinal distress and maintain strength during recovery.

Ongoing monitoring through blood tests, imaging, and clinical assessments allows healthcare providers to tailor treatments based on individual responses. With advances in transplant medicine, survival rates continue to improve, especially when rejection is identified and treated early.