title: UV treatment of chronic skin graft-versus-host disease--focus on UVA1 and extracorporeal photopheresis.
abstract: Chronic graft-versus-host disease (GVHD) is a serious and life-threatening complication after allogeneic hematopoietic stem cell transplantation. Cutaneous manifestations such as lichenoid or sclerotictype skin changes have been frequently observed in these patients. UVA1 phototherapy appears as a very effective treatment option for treatment-refractory lichenoid and sclerodermatous GVHD. Substantial improvements can often be achieved within 8-12 weeks of treatment allowing for subsequent reduction or withdrawal of immunosuppressive medications. UVA1 treatment acts via a local effect and is therefore only indicated for cutaneous manifestations of GVHD. In patients with multiorgan involvement by chronic GVHD, extracorporeal photopheresis is an efficacious and safe secondline therapy for steroid-refractory disease in both pediatric as well as adult patients. Besides high response rates in cutaneous and extracutaneous manifestations of chronic GVHD, a substantial corticosteroid-sparing effect and improved survival rates have been reported in patients given extracorporeal photopheresis treatment.
authors.affiliation: Bone Marrow Transplantation, Department of Internal Medicine I, Medical University of Vienna, Währinger Gürtel 18– 20, Vienna, Austria. hildegard.greinix@meduniwien.ac.at
authors.forename: Hildegard T
authors.initials: HT
authors.lastname: Greinix
authors.forename: Adrian
authors.initials: A
authors.lastname: Tanew
mesh_terms: D000328:Adult; D002648:Child; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D017893:Photopheresis / Q000009:adverse effects / Q000379:methods*; D012871:Skin Diseases / Q000628:therapy*; D014467:Ultraviolet Therapy / Q000379:methods