Daniel R. Couriel, MD, MS

Daniel R. Couriel, MD, MS

Professor of Internal Medicine

Director, Huntsman Cancer Institute (HCI) Blood and Marrow Transplant Program

University of Utah School of Medicine

Salt Lake City, UT

$Although corticosteroids are the standard first therapy for chronic cGVHD (Graft Versus Host Disease), and multiple second-line treatments have been evaluated for patients who are steroid-refractory or steroid-intolerant, what role does ECP play?$ Video

Although corticosteroids are the standard first therapy for chronic cGVHD (Graft Versus Host Disease), and multiple second-line treatments have been evaluated for patients who are steroid-refractory or steroid-intolerant, what role does ECP play?

Daniel Couriel, MD, MS

Video

Are there specific variants or clinical signatures of chronic cGVHD that respond better to ECP therapy than others? What other second line therapies, including ibrutinib, have been evaluated and/or FDA-approved?

Daniel Couriel, MD, MS

Video

In what specific patient populations/disease states is allogeneic hematopoietic cell transplantation (HCT) an important therapeutic option?

Daniel Couriel, MD, MS

Video

Can you characterize the signs, symptoms, and complications of allogeneic cell transplant, in particular acute and chronic GVHD? Can you distinguish between these two forms of GVHD? What were the classifications provided by the NIH consensus?

Daniel Couriel, MD, MS

$What is the difference between acute and chronic GVHD? How is the diagnosis of GVHD made? How is each condition treated? What is the role of steroids as current SOC and what percentage of patients are steroid refractory and potentially require ECP?$ Video

What is the difference between acute and chronic GVHD? How is the diagnosis of GVHD made? How is each condition treated? What is the role of steroids as current SOC and what percentage of patients are steroid refractory and potentially require ECP?

Daniel Couriel, MD, MS

$What is the role of ECP in steroid refractory patients with GVHD? And what is the evidence confirming acceptable response rates and safety of ECP in these patient populations?$ Video

What is the role of ECP in steroid refractory patients with GVHD? And what is the evidence confirming acceptable response rates and safety of ECP in these patient populations?

Daniel Couriel, MD, MS

Video

From a practical implementation perspective, what kind of ports are available for ECP and what is the recommended schedule for deploying ECP in both acute and chronic GVHD? On what basis was this schedule determined?

Daniel Couriel, MD, MS

$Once you have made the decision to deploy ECP as your second-line therapy for steroid-refractory aGVHD or cGVHD, what practical considerations should clinicians be knowledgeable of when considering ECP treatment?$ Video

Once you have made the decision to deploy ECP as your second-line therapy for steroid-refractory aGVHD or cGVHD, what practical considerations should clinicians be knowledgeable of when considering ECP treatment?

Daniel Couriel, MD, MS

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What length of time is typically required to determine whether ECP has been effective for cGVHD, and when might you consider discontinuation of ECP based on a clinical response to ECP? What is the accepted tapering schedule in responders?

Daniel Couriel, MD, MS

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What is the degree of steroid-sparing effect that can be anticipated when using ECP to treat GVHD? And what complications should be considered to be part of an ECP-dominant treatment strategy for GVHD?

Daniel Couriel, MD, MS

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What are the most important randomized studies that support ECP and what do we still need to know about ECP as a foundational, second-line treatment strategy for GVHD?

Daniel Couriel, MD, MS

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How do you taper corticosteroid therapy in acute and chronic GVHD?

Daniel Couriel, MD, MS