title: Extracorporeal photochemotherapy for paediatric patients with graft-versus-host disease after haematopoietic stem cell transplantation.
abstract: This study aimed to ascertain whether extracorporeal photochemotherapy (ECP) is an effective treatment for paediatric patients with refractory graft-versus-host disease (GVHD). From January 1992 to December 2000, 77 children (median age 8.6 years) with either acute (n = 33) or chronic (n = 44) GVHD, resistant to conventional immunosuppressive therapy, were treated with ECP in four Italian paediatric hospitals. After ECP, acute GVHD involving skin, liver and gut responded completely in 76%, 60% and 75% of patients respectively. The 5-year overall survival was 69% for responding patients vs 12% for non-responders (P = 0.001). Among the 44 children with chronic GVHD, 15 (44%) showed a complete response and 10 (29%) a significant improvement after ECP. The 5-year overall survival was 96% for responders vs 58% for non-responders (P = 0.04). Our results suggest that ECP is an effective treatment that may be useful in paediatric patients with either acute or chronic GVHD who have failed to respond to standard immunosuppressive therapy.
authors.affiliation: Paediatric Haematology and Oncology Unit, University of Padua, Italy. Chiara.messina@unipd.it
authors.forename: Chiara
authors.initials: C
authors.lastname: Messina
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.forename: Edoardo
authors.initials: E
authors.lastname: Lanino
authors.forename: Cornelio
authors.initials: C
authors.lastname: Uderzo
authors.forename: Graziella
authors.initials: G
authors.lastname: Zacchello
authors.forename: Simone
authors.initials: S
authors.lastname: Cesaro
authors.forename: Marta
authors.initials: M
authors.lastname: Pillon
authors.forename: Cesare
authors.initials: C
authors.lastname: Perotti
authors.forename: Claudia
authors.initials: C
authors.lastname: Del Fante
authors.forename: Maura
authors.initials: M
authors.lastname: Faraci
authors.forename: Lucia
authors.initials: L
authors.lastname: Rivabella
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Calore
authors.forename: Pietro
authors.initials: P
authors.lastname: De Stefano
authors.forename: Marco
authors.initials: M
authors.lastname: Zecca
authors.forename: Giovanna
authors.initials: G
authors.lastname: Giorgiani
authors.forename: Alessandra
authors.initials: A
authors.lastname: Brugiolo
authors.forename: Adriana
authors.initials: A
authors.lastname: Balduzzi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Dini
authors.forename: Luigi
authors.initials: L
authors.lastname: Zanesco
authors.forename: Roberto
authors.initials: R
authors.lastname: Dall'Amico
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004351:Drug Resistance; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008297:Male; D017893:Photopheresis / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents