{"entity":{"id":"gvhd","kind":"term","name":"Graft-versus-host disease (GVHD) and graft-versus-leukaemia","aka":["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"],"tldr":"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.","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Graft-versus-host_disease","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Graft-versus-host_disease"}],"tags":[],"related":["allogeneic-transplant","conditioning-regimen","irae","crs","gvhd-chronic-overview","gvhd-nih-consensus-criteria","gvhd-organ-by-organ","gvhd-lung-bronchiolitis-obliterans","gvhd-prophylaxis","gvhd-ruxolitinib-steroid-refractory","gvhd-belumosudil-axatilimab-ibrutinib","gvhd-photopheresis"],"cancers":[],"sections":["cell-therapy","rejuvenation"],"technologies":[],"targets":[],"drugs":["ruxolitinib","belumosudil","ibrutinib"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Treatment jargon"},"route":"/terms/gvhd/","neighbours":{"term":[{"id":"allogeneic-transplant","kind":"term","name":"Allogeneic stem cell transplant (allo-SCT)","route":"/terms/allogeneic-transplant/"},{"id":"conditioning-regimen","kind":"term","name":"Conditioning regimen (myeloablative, reduced-intensity)","route":"/terms/conditioning-regimen/"},{"id":"crs","kind":"term","name":"Cytokine release syndrome (CRS)","route":"/terms/crs/"},{"id":"irae","kind":"term","name":"Immune-related adverse events (irAEs)","route":"/terms/irae/"}],"technology":[{"id":"rejuv-tx-what-to-ask-for","kind":"technology","name":"After a transplant or cell therapy: what to ask for","route":"/technologies/rejuv-tx-what-to-ask-for/"},{"id":"gvhd-belumosudil-axatilimab-ibrutinib","kind":"technology","name":"After ruxolitinib: belumosudil, axatilimab and ibrutinib in chronic GvHD","route":"/technologies/gvhd-belumosudil-axatilimab-ibrutinib/"},{"id":"gvhd-chronic-overview","kind":"technology","name":"Chronic graft-versus-host disease","route":"/technologies/gvhd-chronic-overview/"},{"id":"gvhd-organ-by-organ","kind":"technology","name":"Chronic GvHD organ by organ: skin, mouth, eyes, gut, liver, joints and genital tract","route":"/technologies/gvhd-organ-by-organ/"},{"id":"gvhd-photopheresis","kind":"technology","name":"Extracorporeal photopheresis for graft-versus-host disease","route":"/technologies/gvhd-photopheresis/"},{"id":"gvhd-nih-consensus-criteria","kind":"technology","name":"How chronic GvHD is diagnosed and scored: the NIH consensus criteria","route":"/technologies/gvhd-nih-consensus-criteria/"},{"id":"rejuv-tx-infection-by-phase","kind":"technology","name":"Infection risk after transplant and cell therapy, phase by phase, and the prophylaxis that follows it","route":"/technologies/rejuv-tx-infection-by-phase/"},{"id":"gvhd-prophylaxis","kind":"technology","name":"Preventing graft-versus-host disease, and what prevention costs","route":"/technologies/gvhd-prophylaxis/"},{"id":"rejuv-tx-quality-of-life","kind":"technology","name":"Quality of life after transplant and cell therapy","route":"/technologies/rejuv-tx-quality-of-life/"},{"id":"rejuv-tx-immune-reconstitution-timeline","kind":"technology","name":"Rebuilding an immune system: the timeline, lineage by lineage","route":"/technologies/rejuv-tx-immune-reconstitution-timeline/"},{"id":"rejuv-tx-revaccination","kind":"technology","name":"Revaccination after transplant: the schedules, and where the UK and the US differ","route":"/technologies/rejuv-tx-revaccination/"},{"id":"gvhd-lung-bronchiolitis-obliterans","kind":"technology","name":"The lungs after transplant: bronchiolitis obliterans syndrome","route":"/technologies/gvhd-lung-bronchiolitis-obliterans/"},{"id":"gvhd-ruxolitinib-steroid-refractory","kind":"technology","name":"When steroids fail: ruxolitinib for steroid-refractory GvHD","route":"/technologies/gvhd-ruxolitinib-steroid-refractory/"}],"section":[{"id":"cell-therapy","kind":"section","name":"Cell Therapy","route":"/fronts/cell-therapy/"},{"id":"rejuvenation","kind":"section","name":"Recovery & Rejuvenation","route":"/fronts/rejuvenation/"}],"drug":[{"id":"belumosudil","kind":"drug","name":"Belumosudil","route":"/drugs/belumosudil/"},{"id":"ibrutinib","kind":"drug","name":"Ibrutinib","route":"/drugs/ibrutinib/"},{"id":"methoxsalen-ecp","kind":"drug","name":"Methoxsalen (extracorporeal photopheresis)","route":"/drugs/methoxsalen-ecp/"},{"id":"remestemcel-l","kind":"drug","name":"Remestemcel-L","route":"/drugs/remestemcel-l/"},{"id":"ruxolitinib","kind":"drug","name":"Ruxolitinib","route":"/drugs/ruxolitinib/"}],"target":[{"id":"impdh2","kind":"target","name":"IMP dehydrogenase (IMPDH2)","route":"/targets/impdh2/"}],"person":[{"id":"huang-xiaojun","kind":"person","name":"Xiaojun Huang","route":"/people/huang-xiaojun/"}],"trial":[{"id":"msb-gvhd001","kind":"trial","name":"MSB-GVHD001","route":"/trials/msb-gvhd001/"},{"id":"rockstar","kind":"trial","name":"ROCKstar","route":"/trials/rockstar/"}],"paper":[{"id":"paper-msb-gvhd001-bbmt-2020","kind":"paper","name":"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","route":"/key-papers/paper-msb-gvhd001-bbmt-2020/"},{"id":"paper-rockstar-blood-2021","kind":"paper","name":"Belumosudil for chronic graft-versus-host disease after 2 or more prior lines of therapy: the ROCKstar Study","route":"/key-papers/paper-rockstar-blood-2021/"}],"cancer":[{"id":"post-transplant-lymphoproliferative-disorder","kind":"cancer","name":"Post-transplant lymphoproliferative disorder (PTLD)","route":"/cancers/post-transplant-lymphoproliferative-disorder/"}]}}