Extracorporeal photopheresis for the treatment of steroid refractory acute GVHD
| Autor: | Bénédicte Bruno, Stefania Bregante, Adalberto Ibatici, P Perfetti, P Stura, Almalina Bacigalupo, C. Di Grazia, Domenico Occhini, Teresa Lamparelli, P. Carlier, M. T. Van Lint, G M Ferrari, Francesca Gualandi, Enrico Pogliani, Alida Dominietto, Paolo Strada, A M Raiola, S Zia |
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| Přispěvatelé: | Perfetti, P, Carlier, P, Strada, P, Gualandi, F, Occhini, D, Van Lint, M, Ibatici, A, Lamparelli, T, Bruno, B, Raiola, A, Dominietto, A, Di Grazia, C, Bregante, S, Zia, S, Ferrari, G, Stura, P, Pogliani, E, Bacigalupo, A |
| Rok vydání: | 2008 |
| Předmět: |
Male
Adult medicine.medical_specialty Transplantation Conditioning Adolescent medicine.medical_treatment education Drug Resistance Graft vs Host Disease Hematopoietic stem cell transplantation Gastroenterology Young Adult fluids and secretions Photopheresis Retrospective Studie Internal medicine Immunopathology Extracorporeal Photopheresis medicine Humans Steroid Survival rate Retrospective Studies Photopheresi Aged Immunosuppression Therapy Transplantation business.industry Hematopoietic Stem Cell Transplantation Hematology Middle Aged medicine.disease Surgery Survival Rate Treatment Outcome Graft-versus-host disease Methylprednisolone Acute Disease Chronic Disease Steroids Female business Immunosuppression Human medicine.drug |
| Zdroj: | Bone Marrow Transplantation. 42:609-617 |
| ISSN: | 1476-5365 0268-3369 |
| DOI: | 10.1038/bmt.2008.221 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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