There is little you can do to prevent graft-versus-host disease. It is important to watch for early warning signs and take steps to avoid triggering or aggravating GVHD. Doctors use drugs to suppress GVHD and carefully monitor how your body responds to minimize side effects.
Late Complications and Treatment
White sores, raw patches: Immunosuppressants, rinses, lubricants
Dryness, itching, irritation: Frequent use of artificial tears, use of a humidifier, warm compresses, avoiding eye strain and resting your eyes. Depending on severity, you might also ask your doctor about lachrymal duct occlusion, a surgical procedure to reduce the draining of tears.
Cataracts: When symptoms first appear, you might benefit from new glasses or better lighting. If vision becomes seriously impaired, surgery is recommended. It is a simple, relatively painless procedure, with 9 out of 10 patients regaining very good vision.
Severely dry eyes: People suffering from severely dry eyes and who have not benefited from other treatments, might be candidates for the Boston scleral lens. The lens creates a space where artificial tears can continually lubricate the eye.
Skin and joints
Rashes: GVHD of the skin shows up as a red skin rash that is often dry and itchy. The GVHD causing the rash will be treated with immunosuppressants and sometimes corticosteroids.
Scleroderma (Hard skin): Scleroderma is caused by excess collagen deposits that can affect the skin, joints, blood vessels and internal organs. Scleroderma is usually caused by GVHD. It is not contagious or cancerous. It varies in severity and should be treated promptly. Besides medications, proper diet, exercise and physical therapy can also help increase circulation, strength and flexibility.
Avascular necrosis: Avascular necrosis causes bone to break down faster than the body can rebuild it. Joint pain is usually the first symptom. Treatments to reduce pain and prevent further damage include medication, use of crutches or braces, range of motion exercises and electrical stimulation to promote bone growth. More severe cases may require surgery to repair or replace the joint.
Approximately 10 percent of patients with chronic GVHD also develop an inflammation of the lungs, which can lead to breathing problems. This can occur from three months to two years after transplant. Corticosteroids can quickly resolve problems caused by inflammation when treated early.
Atherosclerosis (hardening of the arteries): Atherosclerosis is a buildup of plaque inside an artery. This can reduce blood flow, cause arteries to rupture and cause blood clots. Treatments include diet, exercise and/or lipid-lowering drugs and drugs to control blood pressure.
Chronic GVHD can cause mild or moderate liver damage which can cause a mild loss of appetite. Jaundice (yellowing of the skin) is a common symptom. Most cases can be successfully treated with immunosuppressants.