title: Efficacy of photopheresis extracorporeal procedure as single treatment for severe chronic GVHD: a case report.
abstract: Allogeneic hematopoietic stem cell transplantation is the only potentially curative therapeutic option for many malignant and nonmalignant hematologic disorders. Despite this, several factors unfavorably affect the outcome of this procedure and in particular chronic graft-versus-host disease (cGVHD) remains the principal cause of morbidity after allogeneic transplantation. Here we present our experience regarding a patient affected by extensive chronic GVHD (cGVHD) treated only with extracorporeal photopheresis procedure (ECP) as first line treatment. The patient, presenting an high risk myelodysplastic syndrome (MDS), underwent an allogeneic peripheral stem cells transplantation. About 2 months after transplantation she experienced a hematological and clinical relapse of MDS. After reinduction therapy with azacitidine she obtained a second complete remission. Because of the risk of relapse related to a strong immunosuppressant therapy and the previous infectious complication, we decided to start a treatment with ECP alone for cGVHD. After six procedure the patient obtained a complete resolution of all signs and symptoms of the cGVHD. This experience may support the possibility to use only an immunomodulant treatment like ECP for the cGVHD, reducing the risk of complications of prolonged immunosuppressant treatment.
authors.affiliation: European Institute of Oncology, Hematoncology Divisione, Milan, Italy; Humanitas Cancer Center, Istituto Clinico Humanitas, Istituto Di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy. Electronic address: federica.gigli@ieo.it.
authors.forename: Federica
authors.initials: F
authors.lastname: Gigli
authors.forename: Angelo
authors.initials: A
authors.lastname: Gardellini
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Babic
authors.forename: Sarah Jane
authors.initials: SJ
authors.lastname: Liptrott
authors.forename: Luca
authors.initials: L
authors.lastname: Castagna
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinelli
authors.forename: Daniele
authors.initials: D
authors.lastname: Laszlo
mesh_terms: D000368:Aged; D064591:Allografts; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D017893:Photopheresis; D013997:Time Factors
keywords: Allogeneic stem cells transplantation; Chronic GVHD; Extracorporeal photopheresis procedure