title: [Extracorporeal photopheresis as an alternative therapy for drug-resistant graft versus host disease: three cases].
abstract: BACKGROUND
  Graft versus host reaction is a life-threatening complication of allogenic bone marrow transplantation. Extracorporeal photopheresis has been used for some years in the treatment of graft versus host reaction. We report on three children treated with extracorporeal photopheresis for a graft versus host reaction resistant to immunosuppresive drugs.
  
  
  METHODS
  Three children with a graft versus host reaction were submitted to 18, 30 and 46 extracorporeal photopheresis courses respectively. In the same time, the other immunosuppressive treatments were tapered or definitively stopped (ciclosporin).
  
  
  RESULTS
  A dramatic improvement of cutaneous status and biological data was observed after the first courses. However, the extracorporeal photopheresis treatment did not improve the mucous lesions. No serious adverse effect was encountered.
  
  
  CONCLUSIONS
  As published elsewhere, extracorporeal photopheresis was effective on the graft versus host reaction lichenoid cutaneous lesions and in case of visceral involvement. In all of our cases, the immunosuppressive drug could have been tapered. No adverse event was observed. Thus, extracorporeal photopheresis should be indicated in case of resistance to immunosuppressive drugs.
authors.affiliation: Service de Dermatologie, CHRU-Hôtel-Dieu, BP 69, 63001 Clermont-Ferrand Cedex 01, France.
authors.forename: M
authors.initials: M
authors.lastname: D'incan
authors.forename: J
authors.initials: J
authors.lastname: Kanold
authors.forename: P
authors.initials: P
authors.lastname: Halle
authors.forename: L
authors.initials: L
authors.lastname: De Lumley
authors.forename: P
authors.initials: P
authors.lastname: Souteyrand
authors.forename: F
authors.initials: F
authors.lastname: Deméocq
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy; D008297:Male; D017893:Photopheresis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D016896:Treatment Outcome