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, Valeria Cancelli, Cristina Skert, Pierino Ferremi Leali, Emilio Ferrari, A. Tiburzi, Maria Luisa Sala, I. Donnini, Patrizia Chiusolo, Alberto Muffetti, Marta Lisa Battista, Alessandro Turra, Federica Cattina, Benedetta Rambaldi, Francesca Schieppati, Nicola Polverelli, Simona Bernardi, Simone Perucca, M. Marini, Daniele LaszloChiara Savignano, F. Patriarca, Paolo Corradini, Nicola Piccirillo, Simona Sica, Alberto Bosi, Domenico Russo

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
JournalTransplantation
DOIs
Publication statusAccepted/In press - Sep 8 2016

ASJC Scopus subject areas

  • Medicine(all)
  • Transplantation

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