Symptoms of Graft-Versus-Host Disease (GVHD)
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Graft-Versus-Host Disease (GVHD) Symptoms

Graft-Versus-Host Disease (GVHD) Symptoms
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Published on May 2, 2025
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Graft-versus-host disease (GVHD) is a severe complication that can occur after someone has received a stem cell or bone marrow transplant from a donor. The immune cells from the donor's transplanted tissue (the graft) attack the tissues of the person who received the transplant (the host).

GVHD can be acute or chronic. Depending on the type of GVHD you have and how severe it is, different organs may be affected, causing different symptoms.

Symptoms of GVHD

In acute GVHD, symptoms start to appear within 100 days after the transplant. In chronic GVHD, symptoms typically start after 100 days of the transplant, last longer, and are potentially more severe.

GVHD has different degrees of severity, and symptoms can vary a great deal depending on the stage and type of illness and the organ affected.

 Overall, GVHD tends to affect the skin, digestive tract, liver, and lungs.

 Symptoms can range from a mild skin rash to liver failure.

Speak to your doctor if you've had a transplant and are experiencing any of the symptoms discussed below. Not every skin rash that appears after a transplant is necessarily a sign of GVHD — your physician will consider all your symptoms and history before reaching a diagnosis.

Acute GVHD

Usually, acute GVHD affects the skin, digestive tract, and liver, but it can involve any organ. The symptoms can also vary in severity, from a mild skin rash to bloody diarrhea.

Depending on the organ it affects, acute GVHD can cause the following symptoms:

  • A skin rash that can appear anywhere on the body but typically starts in the palms, soles of the feet, shoulders, and back of the neck. The skin can be mildly red, sore, or itchy, or look like a sunburn. More severe cases can cause the skin to blister or peel off.
  • Diarrhea, which may be accompanied by other symptoms such as blood in the stool
  • Pale pee or stool
  • Nausea and vomiting
  • Stomach ulcers
  • Loss of appetite or unintentional weight loss
  • Jaundice (yellowing of the skin or eyes)
  • Bleeding, confusion, and a buildup of fluid in the abdomen, which can be signs of liver failure

Chronic GVHD

Chronic GVHD can affect a single organ or multiple organs at a time. Symptoms can range from mild to severe and may last anywhere from months to years or even a lifetime. Depending on the organs it affects, chronic GVHD can cause the following symptoms, in addition to the symptoms previously for acute GVHD.

  • Dry, painful, or itchy eyes, sensitivity to light, blurred vision, or blindness
  • Dry mouth, painful mouth sores, difficulty eating, chewing, and swallowing
  • Gum disease or cavities
  • Sensitivity to certain foods and drinks
  • Skin thickening or becoming so tight that it stops your joints from moving properly
  • Ulcers that never heal
  • Intolerance to very hot or very cold temperatures
  • Changes in the way your nails feel or look, brittle nails, or nail loss
  • Hair loss or prematurely gray hair
  • A sensation of food getting stuck in your throat
  • Abdominal (stomach) pain
  • Shortness of breath, persistent cough, or wheezing
  • Swelling in the abdomen
  • Muscle fatigue and cramps
  • Stiff joints
  • Dryness, itching, pain, irritation, ulcerations, or scarring on the genitals
  • Narrowing of the vagina or urethra and painful intercourse

Potential Complications of GVHD

If untreated, GVHD can cause several complications, including:

  • Infections that won't go away or keep coming back
  • Nutritional deficiencies or poor absorption of nutrients
  • Inflammatory conditions that affect the lungs, such as bronchiolitis, interstitial lung disease, and lung fibrosis
  • Inflammation that affects the liver and the bile ducts, causing conditions such as endothelialitis (inflammation of the endothelium, the lining inside blood vessels), bile duct destruction, and pericholangitis (a form of chronic liver disease)
  • Motility problems (food getting stuck in your throat, stomach not emptying properly, constipation, bowel obstruction)
If you don't receive prompt treatment for some of these complications (such as infections) they may become life-threatening or even fatal.

When to See a Doctor

If you've had a transplant and have developed any of the symptoms in this article, you should consult a doctor. Even though many of these symptoms could be caused by something less serious than GVHD, it's important for a physician to examine you. Early intervention and treatment can go a long way in limiting the severity of the illness.

Also, keep in mind that symptoms of chronic GVHD can develop a long time after you've had your transplant (even years later), so it's best you consult a doctor as soon as you've developed symptoms, particularly if they affect your mouth, eyes, skin, genitals, or joints.

The Takeaway

  • Both acute and chronic GVHD can affect several organs and cause symptoms that range from mild to severe.
  • If you've had a transplant, either recently or in the past, it's best to see your doctor if you experience any of these symptoms.
  • Remember that many other conditions that are less serious than GVHD can cause these symptoms, so try not to worry. The best way to figure out what's going on is to see your doctor.
  • There are many therapies available for GVHD, and early diagnosis and treatment can improve your outcome and limit the severity of the illness.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Mayo Clinic Staff. Bone Marrow Transplant. Mayo Clinic. January 31, 2025.
  2. Graft vs. Host Disease. Cleveland Clinic. February 21, 2023.
  3. Vaillant AAJ et al. Graft-Versus-Host Disease. StatPearls. June 7, 2024.
  4. Graft-Versus-Host Disease. Leukemia & Lymphoma Society. 2024.
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Conor Steuer, MD

Medical Reviewer
Castle Connolly Top Doctor

Conor E. Steuer, MD, is medical oncologist specializing in the care of aerodigestive cancers, mesothelioma, and thymic malignancies and an assistant professor in the department of hematology and medical oncology at the Emory University School of Medicine in Atlanta. He joined the clinical staff at Emory's Winship Cancer Institute as a practicing physician in July 2015. He currently serves as chair of the Lung and Aerodigestive Malignancies Working Group and is a member of the Discovery and Developmental Therapeutics Research Program at Winship.

Dr. Steuer received his medical degree from the New York University School of Medicine in 2009. He completed his postdoctoral training as a fellow in the department of hematology and medical oncology at the Emory University School of Medicine, where he was chief fellow in his final year.

He has been active in research including in clinical trial development, database analyses, and investigation of molecular biomarkers. He is interested in investigating the molecular biology and genomics of thoracic and head and neck tumors in order to be able to further the care of these patient populations. Additionally, he has taken an interest in utilizing national databases to perform clinical outcomes research, as well as further investigate rare forms of thoracic cancers.

Steuer's work has been published in many leading journals, such as Cancer, the Journal of Thoracic Oncology, and Lung Cancer, and has been presented at multiple international conferences.

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Ana is a freelance medical copywriter, editor, and health journalist with a decade of experience in content creation. She loves to dive deep into the research and emerge with engaging and informative content everyone can understand. Her strength is combining scientific rigor with empathy and sensitivity, using conscious, people-first language without compromising accuracy.

Previously, she worked as a news editor for Medical News Today and Healthline Media. Her work as a health journalist has reached millions of readers, and her in-depth reporting has been cited in multiple peer-reviewed journals. As a medical copywriter, Ana has worked with award-winning digital agencies to implement marketing strategies for high-profile stakeholders. She’s passionate about health equity journalism, having conceived, written, and edited features that expose health disparities related to race, gender, and other social determinants of health.

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