Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Greinix, HT; Volc-Platzer, B; Rabitsch, W; Gmeinhart, B; Guevara-Pineda, C; Kalhs, P; Krutmann, J; Hönigsmann, H; Ciovica, M; Knobler, RM.
Successful use of extracorporeal photochemotherapy in the treatment of severe acute and chronic graft-versus-host disease.
Blood. 1998; 92(9):3098-3104
Doi: 10.1182/blood.V92.9.3098.421k32_3098_3104
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- Führende Autor*innen der Med Uni Graz
- Greinix Hildegard
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- Abstract:
- Extracorporeal exposure of peripheral blood mononuclear cells to the photosensitizing compound 8-methoxypsoralen and ultraviolet A radiation has been shown to be effective in the treatment of several T-cell-mediated diseases, including cutaneous T-cell lymphoma and rejection after organ transplantation. We present 21 patients (10 men and 11 women) with hematological malignancies with a median age of 36 years (range, 25 to 55 years) who had received marrow grafts from sibling (n = 12) or unrelated (n = 9) donors. Six patients had acute graft-versus-host disease (GVHD) grade II to III not responding to cyclosporine A (CSA) and prednisolone when referred to extracorporeal photochemotherapy (ECP). In 15 patients, 2 to 24 months after bone marrow transplantation (BMT), extensive chronic GVHD with involvement of skin (n = 15), liver (n = 10), oral mucosa (n = 11), ocular glands (n = 6), and thrombocytopenia (n = 3) developed and was unresponsive to conventional therapy, including steroids. All patients were treated with ECP on 2 consecutive days every 2 weeks for the first 3 months and thereafter every 4 weeks until resolution of GVHD. ECP was tolerated excellently without any significant side effects. After a median of 14 cycles of ECP, acute GVHD resolved completely in 4 of 6 patients (67%) and partially in another 2 patients. Cutaneous chronic GVHD completely resolved in 12 of 15 (80%) patients. Contractures of knees and elbows due to scleroderma resolved partially. Oral mucosal ulcerations resolved in all patients. Seven of 10 patients (70%) with liver involvement had complete responses after ECP. After discontinuation of ECP, no severe infections were observed. Our findings suggest that ECP is a safe and effective adjunct therapy for both acute and extensive chronic GVHD with skin and visceral involvement and resistance to conventional therapy. Copyright 1998 by The American Society of Hematology
- Find related publications in this database (using NLM MeSH Indexing)
- Acute Disease -
- Adult -
- Anemia, Aplastic - therapy
- Bone Marrow Transplantation - adverse effects
- Chronic Disease -
- Female -
- Graft vs Host Disease - drug therapy Graft vs Host Disease - mortality
- Hematologic Neoplasms - therapy
- Humans -
- Immunosuppression - methods
- Infection - epidemiology
- Life Tables -
- Male -
- Middle Aged -
- Photopheresis -
- Skin - pathology
- Survival Analysis -
- Treatment Outcome -