Higher response rates in patients with severe chronic skin graft-versus-host disease treated with extracorporeal photopheresis
| Autor: | Mikael Sundin, Emma Watz, Ulla Axdorph Nygell, Gabriel Afram, Jonas Mattsson, Mats Remberger, Hans Hägglund, Michael Uhlin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Immunology lcsh:Medicine Disease Hematopoietic stem cell transplantation ecp Gastroenterology 03 medical and health sciences 0302 clinical medicine immune system diseases Internal medicine hemic and lymphatic diseases Extracorporeal Photopheresis Immunology and Allergy Medicine Platelet Hematologi Hematology treatment business.industry lcsh:R Albumin cGVHD medicine.disease ECP Graft-versus-host disease cgvhd Clinical Immunology business Progressive disease 030215 immunology |
| Zdroj: | Central European Journal of Immunology, Vol 44, Iss 1, Pp 84-91 (2019) Central-European Journal of Immunology |
| Popis: | Introduction Different forms of graft-versus-host disease (GVHD) remain a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). The prognosis for steroid-refractory chronic GVHD (cGVHD) remains poor. Our aim was to evaluate extracorporeal photopheresis (ECP) treatment in cGVHD patients with different organ involvement to detect subgroups of patients with the best response. Material and methods Thirty-four patients who underwent HSCT and developed moderate (n = 7) or severe (n = 27) steroid-refractory or steroid-dependent cGVHD treated with ECP were included in the analysis. A matched cGVHD control patient group untreated with ECP was collected for comparison. Results Compared to the control group and the stable/progressive disease (SD/PD) patients, individuals with complete/partial remission have higher overall survival and lower transplant-related mortality. Furthermore, patients with complete and partial remission (CR/PR) had significantly higher levels of albumin and platelets after ECP treatment compared to patients with stable or progressive cGVHD (SD/PD). Corticosteroid treatment and other immunosuppressive agents could successfully be tapered in the CR/PR group compared to the SD/PD patients. In this study patients with skin cGVHD are those with the highest rate of CR/PR after ECP treatment. Conclusions Our results suggest that ECP treatment is safe and effective for patients with predominantly skin, oral and liver cGVHD. |
| Databáze: | OpenAIRE |
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