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Extracorporeal photopheresis for the treatment of steroid refractory acute GVHD.
- Source :
-
Bone marrow transplantation [Bone Marrow Transplant] 2008 Nov; Vol. 42 (9), pp. 609-17. Date of Electronic Publication: 2008 Jul 28. - Publication Year :
- 2008
-
Abstract
- Extracorporeal photopheresis (ECP) was given to 23 patients with steroid-refractory acute GVHD (aGVHD, grade II (n=10), III (n=7) or IV (n=6)). The median duration of ECP was 7 months (1-33) and the median number of ECP cycles in each patient was 10. Twelve patients (52%) had complete responses. Eleven patients (48%) survived and 12 died, 10 of GVHD with or without infections and two of leukaemia relapse. The average grade of GVHD was reduced from 2.8 (on the first day of ECP) to 1.4 (on day +90 from ECP) (P=0.08), and the average dose of i.v. methylprednisolone from 2.17 to 0.2 mg/kg/d (P=0.004). Complete responses were obtained in 70, 42 and 0% of patients, respectively, with grades II, III and IV aGVHD; complete responses in the skin, liver and gut were 66, 27 and 40%. Patients treated within 35 days from onset of aGVHD had higher responses (83 vs 47%; P=0.1). A trend for improved survival was seen in grade III-IV aGVHD treated with ECP as compared to matched controls (38 vs 16%; P 0.08). ECP is a treatment option for patients with steroid refractory aGVHD and should be considered early in the course of the disease.
- Subjects :
- Acute Disease
Adolescent
Adult
Aged
Chronic Disease
Drug Resistance
Female
Graft vs Host Disease immunology
Hematopoietic Stem Cell Transplantation adverse effects
Humans
Immunosuppression Therapy methods
Male
Middle Aged
Photopheresis adverse effects
Retrospective Studies
Steroids therapeutic use
Survival Rate
Transplantation Conditioning
Treatment Outcome
Young Adult
Graft vs Host Disease drug therapy
Photopheresis methods
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5365
- Volume :
- 42
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Bone marrow transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 18660840
- Full Text :
- https://doi.org/10.1038/bmt.2008.221