Los Angeles, Mar 20: The Transplantation and Cellular Therapy team at Children’s Hospital Los Angeles (CHLA) is leading the way in specialized care for children and adolescents with graft-versus-host disease (GVHD), a serious complication that can arise after bone marrow or stem cell transplants. GVHD occurs when transplanted immune cells attack the recipient’s tissues, potentially affecting multiple organs and ranging from mild to life-threatening.
“While GVHD manifests similarly in adults and children, pediatric treatment requires a specialized approach that prioritizes long-term health, development, and psychological well-being,” said Ashley N. Gray, MD, MS, physician in CHLA’s Cancer and Blood Disease Institute.
GVHD is classified as acute or chronic. Acute GVHD typically develops within the first three months post-transplant and most commonly affects the skin and gut, leading to symptoms like rash, nausea, vomiting, diarrhea, and jaundice. Chronic GVHD develops over months and can result in long-term organ damage, affecting the skin, eyes, mouth, lungs, and joints.
Children and adolescents are particularly at risk if they receive transplants from mismatched donors, older donors, or donors of a different sex, or if they have undergone intensive radiation or chemotherapy. CHLA utilizes advanced donor cell manipulation techniques, including alpha/beta T-cell depletion and GVHD prophylaxis, to reduce the risk of GVHD and protect young patients.
Treatment at CHLA involves multidisciplinary care, including specialists in ophthalmology, dentistry, dermatology, hepatology, pulmonology, and gastroenterology. Corticosteroids remain first-line therapy, while FDA-approved therapies such as Ryoncil, a cellular therapy for steroid-refractory acute GVHD, offer life-saving alternatives. CHLA also provides access to pediatric clinical trials, including liquid or intravenous drug formulations for younger children.
For chronic GVHD, long-term management includes regular follow-ups, psychological support, and coordinated care through CHLA’s Survivorship and Supportive Care Program, ensuring patients and families receive comprehensive care throughout recovery.
“The beauty of a bone marrow transplant is that the donor immune system will eventually adapt and coexist with the patient’s body,” Dr. Gray explained. “Our goal is to minimize complications and prevent long-term effects by recognizing GVHD early and providing timely, expert care.”
