BACKGROUND: Extracorporeal photopheresis (ECP) is considered a valid second-line treatment for acute and chronic graft versus host disease (GVHD). METHODS: Ninety-four patients with acute GVHD (aGVHD) (n = 45) and chronic GVHD (cGVHD) (n = 49), retrospectively recruited in 6 Italian centers, were submitted to ECP for second-line treatment. At the time of ECP, 22 (49%) and 23 (51%) of 45 patients with aGHVD were nonresponsive and in partial remission (PR) after steroids, respectively, and all the 49 patients with cGVHD were steroid refractory. RESULTS: Forty-one (91%) of 45 patients with aGVHD achieved complete remission (CR) after ECP. Fifteen (33%) of 45 patients developed cGVHD. The CR rate in patients who started ECP being nonresponsive and in PR after steroid was 86% and 96%, respectively. After a median follow-up of 20 months (range, 2-72), 15 (33%) of 45 patients developed cGHVD and 16 (35%) of 45 patients died, in 3 cases for aGVHD. A trend for a better survival was seen among patients who started ECP in PR after steroid (80% vs 50% at 2 years; P = 0.07). Overall, 22 (45%) of 49 patients and 17 (35%) of 49 patients with steroid refractory cGHVD achieved CR and PR after ECP, respectively. After a median follow-up of 27 months, 44 (90%) of 49 patients are alive, 21 of whom (48%) are on steroid. CONCLUSIONS: Extracorporeal photopheresis is confirmed as an effective second-line treatment in both aGVHD and cGVHD, because it can induce a response in more than 80% of the patients and a long-term survival in at least 50% of the cases.
BACKGROUND: Extracorporeal photopheresis (ECP) is considered a valid second-line treatment for acute and chronic graft versus host disease (GVHD). METHODS: Ninety-four patients with acute GVHD (aGVHD) (n = 45) and chronic GVHD (cGVHD) (n = 49), retrospectively recruited in 6 Italian centers, were submitted to ECP for second-line treatment. At the time of ECP, 22 (49%) and 23 (51%) of 45 patients with aGHVD were nonresponsive and in partial remission (PR) after steroids, respectively, and all the 49 patients with cGVHD were steroid refractory. RESULTS: Forty-one (91%) of 45 patients with aGVHD achieved complete remission (CR) after ECP. Fifteen (33%) of 45 patients developed cGVHD. The CR rate in patients who started ECP being nonresponsive and in PR after steroid was 86% and 96%, respectively. After a median follow-up of 20 months (range, 2-72), 15 (33%) of 45 patients developed cGHVD and 16 (35%) of 45 patients died, in 3 cases for aGVHD. A trend for a better survival was seen among patients who started ECP in PR after steroid (80% vs 50% at 2 years; P = 0.07). Overall, 22 (45%) of 49 patients and 17 (35%) of 49 patients with steroid refractory cGHVD achieved CR and PR after ECP, respectively. After a median follow-up of 27 months, 44 (90%) of 49 patients are alive, 21 of whom (48%) are on steroid. CONCLUSIONS: Extracorporeal photopheresis is confirmed as an effective second-line treatment in both aGVHD and cGVHD, because it can induce a response in more than 80% of the patients and a long-term survival in at least 50% of the cases.
Authors: Francine M Foss; Xin Victoria Wang; Selina M Luger; Opeyemi Jegede; Kenneth B Miller; Edward A Stadtmauer; Theresa L Whiteside; David E Avigan; Randall D Gascoyne; Daniel Arber; Henry Wagner; Roger K Strair; William J Hogan; Kellie A Sprague; Hillard M Lazarus; Mark R Litzow; Martin S Tallman; Sandra J Horning Journal: Transfusion Date: 2020-07-12 Impact factor: 3.157
Authors: Beatrice Drexler; Andreas Buser; Laura Infanti; Gregor Stehle; Joerg Halter; Andreas Holbro Journal: Transfus Med Hemother Date: 2020-05-19 Impact factor: 3.747
Authors: Timothy J Brown; Cathy Gentry; Suntrea T G Hammer; Christine S Hwang; Madhuri Vusirikala; Prapti A Patel; Karén Matevosyan; Shannan R Tujios; Arjmand R Mufti; Robert H Collins Journal: ACG Case Rep J Date: 2017-03-29
Authors: Lei Wang; Ming Ni; Angela Hückelhoven-Krauss; Leopold Sellner; Jean-Marc Hoffmann; Brigitte Neuber; Thomas Luft; Ute Hegenbart; Stefan Schönland; Christian Kleist; Martin Sill; Bao-An Chen; Patrick Wuchter; Volker Eckstein; William Krüger; Inken Hilgendorf; Ronit Yerushalmi; Arnon Nagler; Carsten Müller-Tidow; Anthony D Ho; Peter Dreger; Michael Schmitt; Anita Schmitt Journal: Front Immunol Date: 2018-10-08 Impact factor: 7.561
Authors: R Knobler; P Arenberger; A Arun; C Assaf; M Bagot; G Berlin; A Bohbot; P Calzavara-Pinton; F Child; A Cho; L E French; A R Gennery; R Gniadecki; H P M Gollnick; E Guenova; P Jaksch; C Jantschitsch; C Klemke; J Ludvigsson; E Papadavid; J Scarisbrick; T Schwarz; R Stadler; P Wolf; J Zic; C Zouboulis; A Zuckermann; H Greinix Journal: J Eur Acad Dermatol Venereol Date: 2020-10-06 Impact factor: 6.166