Graft-versus-host disease (GVHD) symptoms and signs

Don’t ignore the early signs or symptoms of GVHD. Early detection and treatment of GVHD, infections and other side effects from treatment can make a big difference in your long-term recovery and health.

Not everyone experiences all the warning signs of GVHD, but many transplant recipients experience some of them. Some symptoms might develop into long-term problems. Others are temporary and will go away with treatment. Many of the early warning signs for GVHD could also be caused by infection or another side effect. That’s why it’s important to tell your doctor about any changes in your body that you see or feel.

If you have any signs or symptoms:

• Call your transplant team immediately.
• Give your health care team as many details as you can. Tell them when the symptoms started and what you’re feeling. Sometimes your primary care physician or oncologist may not know the signs of GVHD. It’s important for all your doctors to communicate with each other and share information about your health to help them figure out the cause and the best way to treat it.
• Consider wearing a medical alert bracelet to tell others that you received a blood or marrow transplant. Keep a short treatment summary and your doctor’s phone number in your wallet. Then, in case of an emergency, anyone helping you will have this important medical information.

If your child had a transplant, look for early warning signs of GVHD every day. If your child’s old enough, ask specific questions about how he or she feels. Remind your child to tell you about any changes he or she sees or feels right away.

Symptoms to watch for that may be signs of acute GVHD include:

Skin

• Very faint to severe sunburn-like rashes
• Blisters

Stomach

• Nausea that doesn’t go away
• Loss of appetite
• Vomiting (throwing up)
• Feeling full after eating very little

Intestines

• Diarrhea
• Belly pain that doesn’t go away
• Feeling bloated or full of gas
• Blood in your stool

Liver

• Jaundice (your skin or eyes look yellow)
• Dark (tea-colored) urine
• Pain in the upper part of your belly
• Swelling in your legs or belly

Symptoms to watch for that may be signs of chronic GVHD include:

Skin and nails

• Skin texture changes (thickening)
• Nail changes
• Rash
• Unusual hair loss or thinning
• Itchy skin

Joints and muscles

• Arthritis-like symptoms (pain and stiffness)
• Muscle pain, cramps or weakness

Eyes

• Dry eyes
• Irritation that doesn’t go away
• Blurred vision
• Teary eyes

Mouth

• Trouble opening your mouth
• Sores
• Irritation that doesn’t go away
• Chapped lips
• Pain

Lungs

• Cough that doesn’t go away
• Shortness of breath
• Trouble breathing

Digestive system

• Nausea or vomiting (throwing up)
• Diarrhea
• Stomach pain or cramping

Genitals

• Irritation or dryness
• Rash
• Painful intercourse