title: Impact of extracorporeal photopheresis on skin scores and quality of life in patients with steroid-refractory chronic GVHD.
abstract: There are few prospective studies evaluating the role of extracorporeal photopheresis (ECP) in chronic GVHD (cGVHD) and only occasional reports of the effect of ECP on patients' quality of life (QoL). We report a single-centre prospective study of patients undergoing fortnightly ECP for moderate or severe cGVHD. Response was assessed after 6 months of treatment using NIH scoring criteria and reduction in immunosuppression. QoL assessments were undertaken at baseline and at 6 months using the chronic GVHD symptom scale (cGVHD SS) and dermatology life quality index (DLQI). An intention-to-treat analysis showed that 19/38 (50%) of patients had a complete or partial response. Twenty-seven out of 38 patients completed 6 months of ECP treatment and 70% (19/27) had a complete or partial response. Eighty per cent of patients who completed 6 months of ECP treatment had a reduction in immunosuppression dose. A subset of patients completed QoL questionnaires. Seventeen out of 18 patients (94%) showed an improvement in scores. The mean cGVHD SS and mean DLQI score were both significantly lower after 6 months of ECP (22 compared with 36, P=0.012 and 3.4 compared with 6.9, P=0.009, respectively). This study confirms that ECP can lead to objective clinical responses and, in addition, may lead to an improvement in QoL in cGVHD.
authors.affiliation: 1] St John's Institute of Dermatology, St Thomas' Hospital, London, UK [2] Section of Haemato-oncology, The Royal Marsden Hospital, Sutton, UK [3] University College London, Cancer Institute, London, UK.
authors.forename: F L
authors.initials: FL
authors.lastname: Dignan
authors.affiliation: St John's Institute of Dermatology, St Thomas' Hospital, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Aguilar
authors.affiliation: Department of Dermatology, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: J J
authors.initials: JJ
authors.lastname: Scarisbrick
authors.affiliation: 1] Section of Haemato-oncology, The Royal Marsden Hospital, Sutton, UK [2] University College London, Cancer Institute, London, UK.
authors.forename: B E
authors.initials: BE
authors.lastname: Shaw
authors.affiliation: Section of Haemato-oncology, The Royal Marsden Hospital, Sutton, UK.
authors.forename: M N
authors.initials: MN
authors.lastname: Potter
authors.affiliation: Department of Haematology, St Bartholomew's Hospital, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Cavenagh
authors.affiliation: Centre for Haematology, Imperial College, London, UK.
authors.forename: J F
authors.initials: JF
authors.lastname: Apperley
authors.affiliation: Department of Haematology, University College London, London, UK.
authors.forename: A K
authors.initials: AK
authors.lastname: Fielding
authors.affiliation: Department of Haematological Medicine, King's College London Denmark Hill Campus, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Pagliuca
authors.affiliation: Department of Haematological Medicine, King's College London Denmark Hill Campus, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Raj
authors.affiliation: Department of Haematology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
authors.forename: D I
authors.initials: DI
authors.lastname: Marks
authors.affiliation: Department of Haematology, The Churchill Hospital, Oxford, UK.
authors.forename: A
authors.initials: A
authors.lastname: Peniket
authors.affiliation: Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: C
authors.initials: C
authors.lastname: Crawley
authors.affiliation: Department of Haematology, St George's Hospital, London, UK.
authors.forename: M B
authors.initials: MB
authors.lastname: Koh
authors.affiliation: St John's Institute of Dermatology, St Thomas' Hospital, London, UK.
authors.forename: F J
authors.initials: FJ
authors.lastname: Child
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004351:Drug Resistance / Q000276:immunology; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017893:Photopheresis / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D012867:Skin / Q000276:immunology*; D013256:Steroids / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids