Chronic Graft-Versus-Host Disease (GVHD) Program

Our expert team in the Graft-Versus-Host Disease (GVHD) Program at Lurie Children’s is well-equipped to treat this serious condition. Chronic GVHD is a known complication of allogeneic stem cell transplant. With chronic GVHD, the new (donor's) immune system attacks the recipient's body. It is similar to an autoimmune process and creates fibrous tissue or scarring. The incidence varies depending upon the stem cell source used, the age of patient and donor, and other risk factors.

Chronic GVHD may develop following acute GVHD. It may appear after acute GVHD has resolved, or it may occur without any previous acute GVHD. There are many symptoms that need to be evaluated, as this chronic condition may affect one or more organs.


The Lurie Children’s Difference

We offer a multidisciplinary program for patients with chronic GVHD to best treat this complex condition and the numerous organs it can affect. We work with experts across the hospital to create a personalized treatment plan that meets the needs of your child and your family. With this approach, patients have one appointment lasting several hours rather than going to multiple appointments. All health-care practitioners in our program have a specific interest in chronic GVHD. We provide treatment recommendations, both for immunosuppressive therapies as well as for ancillary treatments.

We also ensure that all supportive tests, such as pulmonary function tests, are taking place at the appropriate intervals. The program facilitates necessary referrals, such as referrals for outpatient therapy. We strive to see patients every three months during the active phase of their chronic GVHD. Children also have the opportunity to participate in research protocols that deal with finding better ways to monitor and assess chronic GVHD.

What to Expect

Standard therapy for chronic GVHD is corticosteroids (prednisone) with a calcineurin inhibitor, such as cyclosporine. Every effort is made to lower prednisone to the lowest amount necessary, in order to minimize the side effects of the medication. If your child does not improve on this regimen, we can recommend a number of different therapies. We have significant expertise with extracorporeal photopheresis and pentostatin.

Both of these therapies appear to improve sclerotic manifestations of GVHD, which are often very difficult to treat. We also have experience with other medications that can be used to treat GVHD, such as infliximab, etanercept and sirolimus.

Recommended Follow-up

(Yearly evaluation and more frequently as advised)

  • Physical exam with labs
  • Eye exam
  • Dental exam
  • Pulmonary evaluation
  • Gynecological exam (if of age)
  • Physical therapy evaluation with range of motion testing
  • Endocrine evaluation

Appointments

If you’d like to request an appointment with one of our specialists, call 1.800.543.7362 (1.800.KIDS DOC®) or visit our Appointments page for more information.

Resources

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Conditions We Treat

Philanthropy

Your support is vital in helping us continue to make a difference in the lives of patients and families. Lurie Children’s relies on philanthropic funding to enhance its programs, services and research for children. To learn more, please e-mail the Ann & Robert H. Lurie Children’s Hospital of Chicago Foundation at foundation@luriechildrens.org or call 312.227.7500.