Complete remission of lichen-planus-like graft-versus-host disease (GVHD) with extracorporeal photochemotherapy (ECP).
A 45-year-old female patient with CML underwent allogeneic BMT and developed two episodes of acute GVHD. The first episode of acute cutaneous GVHD grade II (day +17) responded well to systemic CsA and steroids. During the second episode (around day +60) the patient developed erythroderma (grade III), and subsequently signs of lichen-planus-like GVHD. The patient did not respond to increased dosages of prednisolone and CsA. On day +89 extracorporeal photochemotherapy (ECP) was initiated. After four cycles, a significant improvement of erythroderma and lichen-planus-like lesions was documented, and after 12 cycles, a lasting complete remission was achieved. To our knowledge this is the first report of successful treatment of early-onset, lichen-planus-like GVHD after allogeneic BMT with ECP.
Gerber
M
M
Department of Dermatology, University of Vienna, Austria.
Gmeinhart
B
B
Volc-Platzer
B
B
Kalhs
P
P
Greinix
H
H
Knobler
R
R
D000208:Acute Disease; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D016572:Cyclosporine / Q000627:therapeutic use; D005112:Extracorporeal Circulation; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D008010:Lichen Planus; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy; D011239:Prednisolone / Q000627:therapeutic use; D012074:Remission Induction; D012871:Skin Diseases / Q000188:drug therapy* / Q000209:etiology; D014184:Transplantation, Homologous / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone