Acute graft v host disease: developing an extracorporeal photopheresis outreach service

Acute graft v host disease (AGVHD) is the main complication and cause of non-relapse mortality following allogenic hematopoietic stem cell transplantion. It occurs when donor immune cells attack host tissues. The three main organs that AGVHD affects are skin, liver and gastrointestinal tract, with one or more organs being involved. Extracorporeal photopheresis (ECP) is a second-line treatment for AGVHD in patients who fail to respond to high-dose steroids. It is an immuno-modulatory rather than immunosuppressive therapy. However, ECP is only available in a limited number of regional centres. This article describes how an ECP outpatient unit developed and implemented a fast-response ECP outreach facility for a referring hospital with the aim of improving access to treatment for this patient group.