Safety and Outcomes of Extracorporeal Photopheresis With the Therakos Cellex System for Graft-Versus-Host Disease in Pediatric Patients.
Extracorporeal photopheresis (ECP) is a difficult procedure to perform in the pediatric population. This is a retrospective review of 12 pediatric patients who underwent photopheresis with the Therakos Cellex system for graft-versus-host disease (GVHD). Acute GVHD (aGVHD) occurred in 6 patients, and overlap syndrome and chronic GVHD (cGVHD) occurred in 4 and 2 patients, respectively. The ECP regimen was the same for all aGVHD and cGVHD patients: initially, every week (2 sessions/wk) for 2 months; next, every 2 weeks for 2 months; and finally, every month for at least 1 year. Improvement was observed in 7 of 10 aGVHD patients (70%) and in 4 of 6 cGVHD patients (66%). Eleven patients had skin involvement before ECP; 9 of them responded to treatment (81%). Gastrointestinal involvement occurred in 8 patients; 5 of them experienced improvement during ECP treatment (62%). All 4 patients with liver involvement failed to respond. No serious adverse reactions occurred. In conclusion, our study demonstrates that ECP with the Therakos Cellex system is a safe treatment option for GVHD in children, allowing the tapering of immunosuppressants by at least half.
*Bahçeşehir University School of Medicine †Medical Park Antalya Hospital, Pediatric Hematology and Bone Marrow Transplantation Unit §Department of Pediatric Hematology & Oncology, Akdeniz University School of Medicine, Antalya ‡Bahçeşehir University School of Medicine, Medical Park Goztepe Hospital, Pediatric Hematology and Bone Marrow Transplantation Unit, Istanbul, Turkey.
Vedat
V
Uygun
Hayriye
H
Daloglu
Gulsun
G
Karasu
Volkan
V
Hazar
Akif
A
Yeşilipek
D000293:Adolescent; D002405:Catheterization, Central Venous; D002648:Child; D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology / Q000628:therapy*; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D017893:Photopheresis / Q000295:instrumentation* / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012449:Safety; D013256:Steroids / Q000494:pharmacology
D013256:Steroids