# Graft-versus-host disease (GVHD) and graft-versus-leukaemia

Source: https://onco.cc/terms/gvhd/  
OnCo record `gvhd` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

After a donor transplant, the donor's immune cells may attack the patient's skin, gut and liver (graft-versus-host disease) while also hunting down leftover leukaemia (graft-versus-leukaemia). The two effects are linked, so doctors try to keep enough of the second without too much of the first.

## Summary

Acute GVHD (first 100 days: rash, diarrhoea, jaundice) affects 30-50% of recipients; chronic GVHD (skin, mouth, eyes, lungs, joints) can last years and is the main cause of late morbidity. Prophylaxis uses calcineurin inhibitors, methotrexate, post-transplant cyclophosphamide or abatacept; treatment is steroids, then ruxolitinib (REACH2/3), belumosudil, axatilimab or ibrutinib for refractory disease. Donor lymphocyte infusions deliberately provoke graft-versus-leukaemia at relapse. Allogeneic CAR-T and NK products use gene editing or donor selection to avoid GVHD, and CRS is a different, cytokine-driven phenomenon.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: GVHD; GvHD; graft-versus-host; graft-versus-host disease; acute GVHD; chronic GVHD; cGVHD; aGVHD; steroid-refractory GVHD; graft-versus-leukaemia; graft-versus-leukemia; GVL; graft-versus-tumour; GVHD prophylaxis

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Graft-versus-host_disease
- Wikipedia: https://en.wikipedia.org/wiki/Graft-versus-host_disease

## Connected records

- terms: [Allogeneic stem cell transplant (allo-SCT)](https://onco.cc/terms/allogeneic-transplant/), [Conditioning regimen (myeloablative, reduced-intensity)](https://onco.cc/terms/conditioning-regimen/), [Cytokine release syndrome (CRS)](https://onco.cc/terms/crs/), [Immune-related adverse events (irAEs)](https://onco.cc/terms/irae/)
- technologies: [After a transplant or cell therapy: what to ask for](https://onco.cc/technologies/rejuv-tx-what-to-ask-for/), [After ruxolitinib: belumosudil, axatilimab and ibrutinib in chronic GvHD](https://onco.cc/technologies/gvhd-belumosudil-axatilimab-ibrutinib/), [Chronic graft-versus-host disease](https://onco.cc/technologies/gvhd-chronic-overview/), [Chronic GvHD organ by organ: skin, mouth, eyes, gut, liver, joints and genital tract](https://onco.cc/technologies/gvhd-organ-by-organ/), [Extracorporeal photopheresis for graft-versus-host disease](https://onco.cc/technologies/gvhd-photopheresis/), [How chronic GvHD is diagnosed and scored: the NIH consensus criteria](https://onco.cc/technologies/gvhd-nih-consensus-criteria/), [Infection risk after transplant and cell therapy, phase by phase, and the prophylaxis that follows it](https://onco.cc/technologies/rejuv-tx-infection-by-phase/), [Preventing graft-versus-host disease, and what prevention costs](https://onco.cc/technologies/gvhd-prophylaxis/), [Quality of life after transplant and cell therapy](https://onco.cc/technologies/rejuv-tx-quality-of-life/), [Rebuilding an immune system: the timeline, lineage by lineage](https://onco.cc/technologies/rejuv-tx-immune-reconstitution-timeline/), [Revaccination after transplant: the schedules, and where the UK and the US differ](https://onco.cc/technologies/rejuv-tx-revaccination/), [The lungs after transplant: bronchiolitis obliterans syndrome](https://onco.cc/technologies/gvhd-lung-bronchiolitis-obliterans/), [When steroids fail: ruxolitinib for steroid-refractory GvHD](https://onco.cc/technologies/gvhd-ruxolitinib-steroid-refractory/)
- fronts: [Cell Therapy](https://onco.cc/fronts/cell-therapy/), [Recovery & Rejuvenation](https://onco.cc/fronts/rejuvenation/)
- drugs: [Belumosudil](https://onco.cc/drugs/belumosudil/), [Ibrutinib](https://onco.cc/drugs/ibrutinib/), [Methoxsalen (extracorporeal photopheresis)](https://onco.cc/drugs/methoxsalen-ecp/), [Remestemcel-L](https://onco.cc/drugs/remestemcel-l/), [Ruxolitinib](https://onco.cc/drugs/ruxolitinib/)
- targets: [IMP dehydrogenase (IMPDH2)](https://onco.cc/targets/impdh2/)
- people: [Xiaojun Huang](https://onco.cc/people/huang-xiaojun/)
- trials: [MSB-GVHD001](https://onco.cc/trials/msb-gvhd001/), [ROCKstar](https://onco.cc/trials/rockstar/)
- key papers: [A phase 3, single-arm, prospective study of remestemcel-L, ex vivo culture-expanded adult human mesenchymal stromal cells for the treatment of pediatric patients who failed to respond to steroid treatment for acute graft-versus-host disease](https://onco.cc/key-papers/paper-msb-gvhd001-bbmt-2020/), [Belumosudil for chronic graft-versus-host disease after 2 or more prior lines of therapy: the ROCKstar Study](https://onco.cc/key-papers/paper-rockstar-blood-2021/)
- cancers: [Post-transplant lymphoproliferative disorder (PTLD)](https://onco.cc/cancers/post-transplant-lymphoproliferative-disorder/)

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