Stem cell transplant complication gains attention at UW Health

After Susan Derse Phillips had chemotherapy for leukemia, she received a stem cell transplant, getting blood-forming cells from a donor to restore her immune system and attack any remaining leukemia cells.

The procedure apparently cured her leukemia, a type of blood cancer. But her skin turned red, her mouth and eyes became dry and she developed diarrhea, fatigue, bronchitis and pneumonia.

She had graft-versus-host disease, or GVHD, a life-threatening complication of the transplant. Her donors cells the graft werent attacking just her leukemia. They were attacking her skin, her gut, her lungs and other organs essentially, her body, the host.

It got pretty scary pretty quickly, said Phillips, 66, of Madison, who continues to struggle with the condition two years after the transplant.

More than half of patients who get donor stem cell transplants develop GVHD, and at least 20 percent of them die from it, said Dr. Mark Juckett, a hematologist at UW Health. But the complication, which likely is under-reported, receives relatively little attention.

Phillips, former president and CEO of Agrace HospiceCare in Fitchburg, set out to change that in Wisconsin. With $500,000 from two donors as seed money, she persuaded UW Health to launch a program to focus on the condition.

UW Carbone Cancer Centers new GVHD program aims to provide better treatment for the 250 or so UW Health patients with the condition and up to 1,000 such patients in Wisconsin and parts of neighboring states, said Juckett, one of the programs two leaders. The program will also study ways to prevent GVHD.

Too often, when doctors give donor stem cell transplants, were trading one disease for another, said Juckett, Phillips doctor. Theres been a lot of focus on how best to do the transplant ... but theres never been a real recognition of dealing with GHVD as a real problem.

Nationwide, about 18,500 stem cell or bone marrow transplants were performed in 2011, according to the Center for International Blood and Marrow Transplant Research in Milwaukee.

At UW Hospital, about 150 patients receive the transplants each year. Roughly 100 of them get infusions of their own stem cells, after high-dose chemotherapy or radiation, for conditions such as multiple myeloma and non-Hodgkins lymphoma. They are not at risk for GVHD.

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Stem cell transplant complication gains attention at UW Health