BACKGROUND: Extracorporeal photopheresis (ECP) is considered a valid second-line treatment for acute and chronic graft versus host disease (GVHD). METHODS: Ninety-four patients with aGVHD (n=45) and cGVHD (n=49), retrospectively recruited in 6 Italian Centers, were submitted to ECP for second-line treatment. At the time of ECP, 22 (49%) and 23 (51%) out of 45 patients with aGHVD were non responsive (NR) and in partial remission (PR) after steroids, respectively, and all the 49 patients with cGVHD were steroid refractory. RESULTS: Forty-one out of 45 (91%) patients with aGVHD achieved complete remission (CR) after ECP. Fifteen out of 45 (33%) patients developed cGVHD. The CR rate in patients who started ECP being NR and in PR after steroid was 86% and 96%, respectively. After a median follow up of 20 months (range 2–72), 15/45 patients (33%) developed cGHVD and 16/45 patients (35%) died, in 3 cases for aGVHD. A trend for a better survival was seen among patients who started ECP in PR after steroid (80% vs 50% at 2 years; p=0,07). Overall, 22/49 (45%) and 17/49 (35%) patients with steroid refractory cGHVD achieved CR and PR after ECP, respectively. After a median follow up of 27 months, 44/49 patients (90%) are alive, 21 of whom (48%) on steroid. CONCLUSIONS: ECP is confirmed as an effective second-line treatment in both acute and chronic GVHD, as it can induce a response in more than 80% of the patients and a long term survival in at least 50% of the cases.

Extracorporeal photopheresis (ecp) for treatement of acute and chronic graft versus host disease : an Italian multicentric retrospective analysis on 94 patients on behalf of the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) / M. Malagola, V. Cancelli, C. Skert, P.F. Leali, E. Ferrari, A. Tiburzi, M.L. Sala, I. Donnini, P. Chiusolo, A. Muffetti, M. Battista, A. Turra, F. Cattina, B. Rambaldi, F. Schieppati, N. Polverelli, S. Bernardi, S. Perucca, M. Marini, D. Laszlo, C. Savignano, F. Patriarca, P. Corradini, N. Piccirillo, S. Sica, A. Bosi, D. Russo. - In: TRANSPLANTATION. - ISSN 0041-1337. - 100\:12(2016), pp. E147-E155.

Extracorporeal photopheresis (ecp) for treatement of acute and chronic graft versus host disease : an Italian multicentric retrospective analysis on 94 patients on behalf of the Gruppo Italiano Trapianto di Midollo Osseo (GITMO)

B. Rambaldi;P. Corradini;
2016

Abstract

BACKGROUND: Extracorporeal photopheresis (ECP) is considered a valid second-line treatment for acute and chronic graft versus host disease (GVHD). METHODS: Ninety-four patients with aGVHD (n=45) and cGVHD (n=49), retrospectively recruited in 6 Italian Centers, were submitted to ECP for second-line treatment. At the time of ECP, 22 (49%) and 23 (51%) out of 45 patients with aGHVD were non responsive (NR) and in partial remission (PR) after steroids, respectively, and all the 49 patients with cGVHD were steroid refractory. RESULTS: Forty-one out of 45 (91%) patients with aGVHD achieved complete remission (CR) after ECP. Fifteen out of 45 (33%) patients developed cGVHD. The CR rate in patients who started ECP being NR and in PR after steroid was 86% and 96%, respectively. After a median follow up of 20 months (range 2–72), 15/45 patients (33%) developed cGHVD and 16/45 patients (35%) died, in 3 cases for aGVHD. A trend for a better survival was seen among patients who started ECP in PR after steroid (80% vs 50% at 2 years; p=0,07). Overall, 22/49 (45%) and 17/49 (35%) patients with steroid refractory cGHVD achieved CR and PR after ECP, respectively. After a median follow up of 27 months, 44/49 patients (90%) are alive, 21 of whom (48%) on steroid. CONCLUSIONS: ECP is confirmed as an effective second-line treatment in both acute and chronic GVHD, as it can induce a response in more than 80% of the patients and a long term survival in at least 50% of the cases.
medicine (all); transplantation
Settore MED/15 - Malattie del Sangue
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/443875
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