In Acute Graft Versus Host Disease (aGVHD), we would like to examine whether early and intensified delivery of ECP as part of standard prophylaxis will decrease overall corticosteroid exposure while preserving expected relapse rates in patients undergoing unrelated donor hematopoietic stem cell transplantation (HSCT).
Chronic GVHD (cGVHD) is common after HSCT (30-50% recipients) and is a major contributor to late transplant-related mortality. In cGVHD, ECP has resulted in increased numbers of circulating T regulatory cells (“T regs”). Those are known to inhibit T cell alloreactivity, and may promote the development of immune tolerance. We would like to determine whether preemptive treatment with ECP will prevent or lessen cGVHD severity