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.
(Yearly evaluation and more frequently as advised)
Physical exam with labs
Gynecological exam (if of age)
Physical therapy evaluation with range of motion testing
Patients are seen by Morris Kletzel, MD, head of Hematology, Oncology and Stem Cell Transplant and Kimberly Thormann, APN, a nurse-practitioner with expertise in chronic GVHD. Our team also includes an ophthalmologist, a physical therapist, a nutritionist and a social worker.
If you’d like to request an appointment with one of our specialists, call 1.800.543.7362 (1.800.KIDS DOC®).
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