Wednesday, June 28, 2017
In 2003, Matthew W was diagnosed with Stage-3 Hodgkin's Lymphoma at age 15, a cancer that attacks the body's immune system. After being treated with chemotherapy and radiation, he was cancer free but suffered two relapses in six years. As a result, in 2006 he received an autologous bone marrow transplant and in 2009 received another transplant, only this time it was allogeneic transplant.
With autologous transplants, doctors remove part of the patient's own bone marrow before starting the high intensity chemotherapy to target the malignant cancer cells, then re-infuse it after the patient is treated. Allogeneic transplants are bone marrow transplants where bone marrow from a healthy donor is utilized instead. The autologous bone marrow transplant is considered safer for patients because they typically do not reject their own cells. Sometimes a patient receives an allogeneic transplant when their own bone marrow isn't adequate or is unhealthy.
In 2015 Matt began to notice a drastic decline in his lung function and realized he was experiencing a post allogeneic transplant complication known as Graft versus Host Disease (GvHD). Graft versus Host Disease has many ways of expressing itself. The most common complications are skin rash and diarrhea which tend to show up early and are manageable. Although much less common, GvHD can cause severe pulmonary complications, scaring of the lungs and decreased lung function. This scarring can build up over time and result in such poor lung function that the easiest of tasks can be hard for patients. The disease can progress to the point where a patient needs a lung transplant. Most times GvHD appears within the first two years after transplant, however in Matt's case if was nearly 4 years after his transplant.
"Basically, my donated immune system (graft) started attacking my native lungs(host)," explained Matt.
One of the best ways to spot signs of problems with the lungs is to monitor lung function via spirometry. Directly following transplant the patient's lung function is monitored every 6 weeks for the next two years. At home monitoring of lung function post bone marrow transplant has the potential to alert doctors and patients to early warning signs of decreased lung function. Matt explained that "Patient's don't often notice lung function decline until it has progressed significantly. Early detection is essential to spot and successfully treat pulmonary complications caused by GvHD."
Incredibly, Matt's 14-year battle with cancer is an asset to him at his job at Duke University Health System where he is a clinical research coordinator in the Bone Marrow Transplant Department. His personal experience enables him to relate to patients who are experiencing what he has dealt with himself.
Because respiratory complications caused by GvHD are life threatening, Matt and his research colleagues at Duke are conducting a clinical trial to remotely monitor lung function. The trial will utilize PMD Healthcare's Spiro PD 2.0 Spirometer and remote monitoring Wellness Management Services Platform in allogenous bone marrow transplant patients. The trial will evaluate if home spirometry can identify lung function decline sooner than the standard pulmonary functions tests done less frequently in the clinic. The trial will evaluate the effectiveness of early identification of lung function decline and its success in early referral to treatment.
One of the biggest problems in health care is that patients want to get better, but feel as if they can do nothing about it themselves. Home monitoring devices engage patients in their care and help them track their own progress.
"In a couple of years, it won't be if you are using spirometry at home, it will be which spirometer you choose to send patients home with," said Meg Telfer, PMD South Eastern Healthcare Sales Director.
One can live with their lungs only functioning at a capacity of 65%; in early May, Matt's lung capacity, because of the GvHD, was down to 20%. Matt said he was grateful to have his Spiro PD 2.0 because it let him know his lung function was low but stable. This past month Matt received a successful double lung transplant and is now breathing a lot easier!
PMD is now launching several new products including its second-generation spirometer, Spiro PD 2.0, and its HIPPA compliant Wellness Management System (WMS). The introduction of the second-generation Spiro PD 2.0 device and HIPPA compliant Wellness Management System (WMS) introduces the use of telemonitoring technology via WIFI to connect patients, providers and caregivers anytime and anywhere.
To learn more about PMD Healthcare, please visit www.MyPMD.com.