Efficacy of bimonthly extracorporeal photopheresis in refractory chronic mucocutaneous GVHD. Bone Marrow Transplant 2012 Jun;47(6):824-30
Date
09/20/2011Pubmed ID
21927038DOI
10.1038/bmt.2011.186Scopus ID
2-s2.0-84862196374 (requires institutional sign-in at Scopus site) 62 CitationsAbstract
Extracorporeal photopheresis (ECP) has become a recognised treatment for steroid-refractory chronic GVHD (cGVHD), but the optimal frequency and duration of treatment are yet to be established. We report on 82 consecutive patients with mucocutaneous cGVHD who received a bimonthly regimen of ECP treatment for two consecutive days, which could be subsequently tapered to a monthly regimen depending on response. Patients were steroid-refractory, steroid-dependent or steroid-intolerant, and 29 (35%) had multiorgan involvement. The median duration of treatment was 330 days (42-987). The median number of ECP cycles was 15 (1.5-32). Response was assessed by clinical assessment and reduction in immunosuppression after 6 months. 69/82 (84%) had completed 6 months of ECP and 65/69 (94%) had ≥ 50% improvement in symptoms and signs of cGVHD. A total of 77% of patients who completed 6 months of ECP had a reduction in immunosuppression dose and 80% had decreased their steroid dose (27.5% stopped, 30% had ≥ 75% reduction, 17.5% had ≥ 50% reduction and 25% had <50% reduction). OS at 3 years from the start of ECP was 69%. This study reports the largest series of patients receiving bimonthly ECP treatment for cGVHD, and confirms that ECP allows successful reduction of immunosuppression.
Author List
Dignan FL, Greenblatt D, Cox M, Cavenagh J, Oakervee H, Apperley JF, Fielding AK, Pagliuca A, Mufti G, Raj K, Marks DI, Amrolia P, Peniket A, Medd P, Potter MN, Shaw BE, Scarisbrick JJAuthor
Bronwen E. Shaw MBChB, PhD Center Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Chronic Disease
Female
Graft vs Host Disease
Hematologic Neoplasms
Humans
Male
Middle Aged
Photopheresis
Skin Diseases
Time Factors
