TY - JOUR
T1 - EXTRACORPOREAL PHOTOPHERESIS (ECP) FOR TREATEMENT OF ACUTE AND CHRONIC GRAFT VERSUS HOST DISEASE
T2 - AN ITALIAN MULTICENTRIC RETROSPECTIVE ANALYSIS ON 94 PATIENTS ON BEHALF OF THE GRUPPO ITALIANO TRAPIANTO DI MIDOLLO OSSEO (GITMO)
AU - Malagola, M.
AU - Cancelli, Valeria
AU - Skert, Cristina
AU - Leali, Pierino Ferremi
AU - Ferrari, Emilio
AU - Tiburzi, A.
AU - Sala, Maria Luisa
AU - Donnini, I.
AU - Chiusolo, Patrizia
AU - Muffetti, Alberto
AU - Battista, Marta Lisa
AU - Turra, Alessandro
AU - Cattina, Federica
AU - Rambaldi, Benedetta
AU - Schieppati, Francesca
AU - Polverelli, Nicola
AU - Bernardi, Simona
AU - Perucca, Simone
AU - Marini, M.
AU - Laszlo, Daniele
AU - Savignano, Chiara
AU - Patriarca, F.
AU - Corradini, Paolo
AU - Piccirillo, Nicola
AU - Sica, Simona
AU - Bosi, Alberto
AU - Russo, Domenico
PY - 2016/9/8
Y1 - 2016/9/8
N2 - 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.
AB - 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.
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U2 - 10.1097/TP.0000000000001466
DO - 10.1097/TP.0000000000001466
M3 - Article
JO - Transplantation
JF - Transplantation
SN - 0041-1337
ER -