DUE TODAY 07/14
Respond with at least 150 words (each) to a classmates
Question:
An adult patient with a chronic myelogenous leukemia sits down with you to discuss his questions and concerns about his upcoming bone marrow transplant. He has already received some educational materials and participated in a family conference during which health team members described the procedure and potential complications. He has been told that he has a risk of graft rejection or graft versus host disease (GVHD), but he does not understand the distinction (Chapter 12, Learning Objectives 1, 2, 10, 11).
- What are the similarities between graft versus host disease and graft rejection?
- What are the pathophysiologic differences between graft versus host disease and graft rejection?
- How would these differences be manifested clinically?
- Studies have shown a protective effect of mild to moderate GVHD in cancer patients who have had a bone marrow transplant. Based on your understanding, can you explain these findings?
classmate:
GvHD and Graft rejection
What are the similarities between graft versus host disease and graft rejection?
A graft-versus-host disease (GVHD) develops when the recipient's bodily cells are attacked by the graft's immune cells because they see the host as alien. In this case, the "host" refers to the recipient's tissues, whereas "graft" refers to transplanted or donated tissue. Graft rejection typically develops minutes or hours after transplantation and is brought on by specific antibodies against the graft. Graft rejection and graft versus host disease share a number of similarities. First of all, they both involve an attack on the autoimmune system of the body, and this attack involves the donated organs or tissues (Nagler et al., 2021). Also, both conditions are difficult to prevent and hence, people must take precautions to lower the likelihood of contracting such illnesses. Lastly, both conditions can be managed by immunosuppressive medications that include corticosteroids.
What are the pathophysiologic differences between graft versus host disease and graft rejection?
In regards to the pathophysiologic differences, while GVHD is brought on by donor-derived immune cells reacting against allogeneic recipient tissues, graft rejection involves the immunological reactivity of the recipient against transplanted allografts. The recipient's tissues in the GVHD condition are attacked by the graft because it perceives them as foreign substances. This may happen following an organ transplant. On the other hand, according to Nunes and Kanakry, (2019), graft rejection happens when tissues that have been transplanted are rejected. In other words, GVHD is caused by the recipients' immune systems reacting negatively to donor-derived immune cells, while graft rejection is caused by recipients' immune systems reacting negatively to transplants.
How would these differences be manifested clinically?
The differences between the two conditions are manifested when in GVHD, the recipient is rejected by the donor's immune system, while Graft rejection manifests when the transplant recipient's immune system rejects the transplanted tissue. Clinical symptoms of GVHD include dry eyes, skin discolorations, abdominal swelling, shortness of breath, and trouble swallowing. Also, the condition can result in tiredness and weak muscles. On the other hand, the clinical signs of graft rejection include organ swelling or pain, flu-like symptoms such as nausea, coughing, and body pains, as well as general malaise and discomfort (Nagler et al., 2021). Note that, the reduction in active donor T-cells prevents GVHD by properly cross-matching or tissue-typing, graft rejection can be avoided.
Studies have shown a protective effect of mild to moderate GVHD in cancer patients who have had bone marrow transplants. Based on your understanding, can you explain these findings? GVHD is not always a bad event since mild GVHD can be seen as being advantageous if the transplant is performed to treat blood malignancy. The new cells GvHD actively eradicate any remaining cancer cells in the body and hence, a patient's risk of their cancer coming back after transplant may be reduced if they have mild GVHD. According to Hill and Koyama, (2020), patients with cancer who have undergone bone marrow transplantation may benefit from GVHD, because the tissues and organs of the patient are likely to be recognized as foreign by the donor's immune system. Although mild to moderate GVHD is most likely to affect cancer patients, the condition will likely get better with time.
