Chronic sclerodermic graft-versus-host disease refractory to immunosuppressive treatment responds to UVA1 phototherapy.
Graft-versus-host disease is a frequent complication of allogenic bone marrow transplantation. Approximately 10% of patients suffering from chronic graft-versus-host disease develop sclerodermic graft-versus-host disease of the skin, which often does not respond to conventional immunosuppressive therapy. An alternative to immunosuppressive treatment is photochemotherapy. We describe a patient with chronic sclerodermic graft-versus-host disease who did not respond to a combination therapy of cyclosporine and prednisone and later mycophenolate mofetil plus prednisone. A combination therapy of mycophenolate mofetil (2 g/day) and low-dose UVA(1) therapy (single dose, 20 J/cm(2), 4 times per week over 6 weeks) resulted in striking clinical improvement of sclerodermic graft-versus-host disease.
Grundmann-Kollmann
M
M
Department of Dermatology, University of Ulm, Germany.
Behrens
S
S
Gruss
C
C
Gottlöber
P
P
Peter
R U
RU
Kerscher
M
M
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002908:Chronic Disease; D003131:Combined Modality Therapy; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology / Q000532:radiotherapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D012594:Scleroderma, Localized / Q000209:etiology / Q000532:radiotherapy*; D014467:Ultraviolet Therapy
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid