Extracorporeal photopheresis for treatment of chronic graft-versus-host disease

Cellular Therapy and Transplantation

Liudmila S. Zubarovskaya¹  Tatiana A. Bykova¹  Andrey V. Kozlov¹  Maria A. Estrina¹  Elena V. Semenova¹  Boris V. Afanasyev¹ 

关键词: allo-HSCT;    cGVHD;    extracorporeal photopheresis;   

DOI  :  10.3205/ctt-2011-No12-abstract57

学科分类：肿瘤学

来源: Universitaetsklinikum Hamburg - Eppendorf / University Medical Center Hamburg - Eppendorf

【 摘 要 】

Chronicgraft-versus-hostdisease(cGVHD)isthemostseriousandcommonlong-termcomplicationofallo-HSCT.Itisthemaincauseofnon-relapsemortalityandmorbidityinlong-termsurvivors.Inrecentyearsextracorporealphotopheresis(ECP)hasbeenusedasasecondlinetreatment:eitherincombinationwithotherimmunosuppressivedrugsoraloneinsteroid-dependentandrefractorycGVHD.Theaim:ToevaluatetheeffectivenessofECPforthetreatmentofcGVHDinpatientsafterallo-HSCT.Patientsandmethods:Twenty-fivepatients(15childrenandadolescents,10adults),agedfrom2to51y.o.(median22y)withALL(n=6),AML(n=9),MDS(n=2),CML(n=4),andotherdiagnoses(n=4)wereincludedinthestudy.Allptsreceivedallo-HSCT:fromunrelated(12pts(48%)),andrelated(13pts(52%))donors.ThetypeofcGVHDaccordingtoNIHcriteriawas:progressive:16pts(24%),quiescent:12pts(48%),denovo:5pts(20%),andoverlap:5pts(20%).Theresponsetocorticosteroidswasdependent(n=17),refractory(n=4),andintolerant(n=4).ECPtreatmentprotocolwas2timesevery2weeksor2timesevery4weeks.Patientsreceivedfrom1to20proceduresofECP(median8).Results:CompleteandpartialresolutionofcGVHDsignswasachievedin21pts(84%).Thedoseofcorticosteroidwasreducedorstoppedin53%pts.Abetterresponseratewasseeninskin(64%),gastro-intestinaltract(61%),oralmucosa(55%)andlung(50%)cGVHD.Conclusions:ECPisaneffectivemethodfortreatmentofsteroid-refractory,steroid-dependentandsteroid-intolerantcGVHD.

【 授权许可】

Unknown