Extracorporeal photochemotherapy for paediatric patients with graft-versus-host disease after haematopoietic stem cell transplantation.
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.
Messina
Chiara
C
Paediatric Haematology and Oncology Unit, University of Padua, Italy. Chiara.messina@unipd.it
Locatelli
Franco
F
Lanino
Edoardo
E
Uderzo
Cornelio
C
Zacchello
Graziella
G
Cesaro
Simone
S
Pillon
Marta
M
Perotti
Cesare
C
Del Fante
Claudia
C
Faraci
Maura
M
Rivabella
Lucia
L
Calore
Elisabetta
E
De Stefano
Pietro
P
Zecca
Marco
M
Giorgiani
Giovanna
G
Brugiolo
Alessandra
A
Balduzzi
Adriana
A
Dini
Giorgio
G
Zanesco
Luigi
L
Dall'Amico
Roberto
R
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
D007166:Immunosuppressive Agents