Six months after his transplant for autoimmune hepatitis, stem-cell patient Craig Beary, of Clarion, started experiencing the symptoms of chronic graft vs. host disease (GVHD). After losing about 60 pounds and suffering severe breathing problems, he started photopheresis, a treatment in which some of his white blood cells are exposed to ultraviolet light to help control his symptoms.
“This treatment is a huge reason why I am doing well today,” Beary said.
With the number of stem-cell transplants growing nationally, a new clinic at the Hillman Cancer Center is providing long-term follow-up care to patients who develop GVHD, a common condition after transplantation.
Traditionally, patients with blood malignancies and other disorders who undergo a stem-cell transplant are seen in a specific post-transplant clinic up until 100 days after their transplant at the UPMC CancerCenter’s Mario Lemieux Center for Blood Cancers. They are then seen in their transplant physician’s own clinic for follow-up care. But because after-care for these patients is so specialized, UPMC doctors decided to create a dedicated clinic to provide adjunct long-term care so that complications may be detected early and managed more efficiently.
“Studies have shown that stem-cell patients who are seen at dedicated GVHD clinics may have improved quality of life,” said Mounzer Agha, M.D., director of the Mario Lemieux Center for Blood Cancers and clinical director of the Stem Cell Transplant Program in the Division of Hematology-Oncology at the University of Pittsburgh Cancer Institute, partner with UPMC CancerCenter. “We are committed to the highest quality care for our patients and believe that being there with them every step of the way after transplant is the best approach to care.”
Stem-cell transplants can be done for patients with a range of hematologic disorders and malignancies, including leukemias, lymphomas and multiple myelomas. GVHD occurs when transplanted cells attack the body. Chronic GVHD usually develops several months after transplant and can last a lifetime, with symptoms including fatigue, changes in vision or taste, shortness of breath, skin irritations and weight loss, among many others.
“The key to treating GVHD is early detection. Having a clinic dedicated to these patients will not only help to identify signs of this illness earlier but also will help to manage symptoms better,” said Stanley Marks, M.D., chairman of UPMC CancerCenter.
Annie Im, M.D., assistant professor of medicine in Pitt’s Division of Hematology Oncology, said that they provide focused, multidisciplinary and comprehensive care that is required for transplant patients, due to the unique risk factors and potential complications after transplant. Patients can be seen at the clinic every three to six months, depending on their specific needs.
“This clinic is a great example of the kind of specialty care that we provide for our patients,” Dr. Im said. “By recognizing the complications of GVHD at their earliest stages, we can help these patients better navigate their well-being after transplant.”