Extracorporeal Photopheresis and Mesenchymal Stem Cell Infusion for GVHD

Inclusion Criteria

• •One of the following diagnoses:
• •-High risk aGVHD, either biopsy proven or clinical diagnosed as defined by either:
• •Skin stage 4
• •Lower gastrointestinal (GI) stage ≥ 3
• •Liver stage ≥ 3
• •Skin stage 3 and lower GI or liver stage ≥ 2 GVHD
• •Hyper-acute GVHD as defined by aGVHD within the first 14 days of transplant
• •Overall grade 2-4 aGVHD with high-risk disease identified by the Viracor Eurofins Symptomatic Onset or Post-Treatment Algorithm
• •OR:
• •-Steroid refractory aGVHD (either biopsy proven or clinical diagnosed) as defined by any one of the following criteria per NCCN (National Comprehensive Cancer Network) Guidelines for Hematopoietic Cell Transplantation (HCT):
• •Progression of aGVHD within 3-5 days of therapy onset with ≥ 2 mg/kg/day of methylprednisolone or equivalent
• •Failure to improve within 5-7 days of treatment initiation (2 mg/kg/day of methylprednisolone or equivalent)
• •Incomplete response after more than 28 days of immunosuppressive treatment including steroids (2 mg/kg/day of methylprednisolone or equivalent)
• •* Hct \> 27 and plts \> 50,000 x10\^9/L (may be achieved via transfusion on ECP days)
• •* Candidate for appropriate vascular access for ECP, which may include: (1) peripheral IV with 16 or 17 gauge Fistula needle; (2) central venous access device (apheresis catheter, tunneled central vascular access device), (3) vortex implanted port; (4) Bard POWERFLOW® implanted port
• •* Eastern Cooperative Oncology Group Performance status ≤ 3
• •* Participants who underwent an allogeneic hematopoietic stem cell transplantation from any donor source
• •* Participants must have the ability to understand and the willingness to sign a written informed consent document.