The effect of intensified extracorporeal photochemotherapy on long-term survival in patients with severe acute graft-versus-host disease.
Acute graft-versus-host disease (GVHD) is a major cause of mortality after allogeneic hematopoietic stem cell transplantation. We performed a phase II study on patients with acute steroid-refractory GVHD grades II to IV given extracorporeal photochemotherapy (ECP) weekly and analyzed response and long-term survival. Complete resolution of GVHD was achieved in 82% of patients with cutaneous involvement, 61% with liver involvement, and 61% with gut involvement. The probability of survival was 59% among patients who responded completely to ECP compared to 11% in patients not responding completely. We conclude that intensified ECP is highly effective in acute GVHD and that sustained responses are associated with over 50% long-term survival.
Greinix
Hildegard T
HT
Medical University of Vienna, Department of Internal Medicine I, Bone Marrow Transplantation, Austria. hildegard.greinix@meduniwien.ac.at
Knobler
Robert M
RM
Worel
Nina
N
Schneider
Barbara
B
Schneeberger
Achim
A
Hoecker
Paul
P
Mitterbauer
Margit
M
Rabitsch
Werner
W
Schulenburg
Axel
A
Kalhs
Peter
P
D000328:Adult; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality* / Q000532:radiotherapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D017893:Photopheresis / Q000379:methods; D010865:Pilot Projects; D015996:Survival Rate; D013995:Time