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ctt-journal > Bykova et al. (Abstract)

Bykova et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract57

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

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Extracorporeal photopheresis for treatment of chronic graft-versus-host disease

Tatiana A. Bykova, Andrey V. Kozlov, Maria A. Estrina, Elena V. Semenova, Liudmila S. Zubarovskaya, Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, St. Petersburg Pavlov State Medical University, St. Petersburg, Russia

Correspondence: Tatiana A. Bykova, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, St. Petersburg Pavlov State Medical University, 6/8, Tolstoy str., St. Petersburg, 197022, Russia, E-mail: pishi_skorei@spam is badlist.ru

Abstract

Chronic graft-versus-host disease (cGVHD) is the most serious and common long-term complication of allo-HSCT. It is the main cause of non-relapse mortality and morbidity in long-term survivors. In recent years extracorporeal photopheresis (ECP) has been used as a second line treatment: either in combination with other immunosuppressive drugs or alone in steroid-dependent and refractory cGVHD.

The aim: To evaluate the effectiveness of ECP for the treatment of cGVHD in patients after allo-HSCT.

Patients and methods: Twenty-five patients (15 children and adolescents, 10 adults), aged from 2 to 51 y.o. (median 22 y) with ALL (n=6), AML (n=9), MDS (n=2), CML (n=4), and other diagnoses (n=4) were included in the study. All pts received allo-HSCT: from unrelated (12 pts (48%)), and related (13 pts (52%)) donors. The type of cGVHD according to NIH criteria was: progressive: 16 pts (24%), quiescent: 12 pts (48%), de novo: 5 pts (20%), and overlap: 5 pts (20%). The response to corticosteroids was dependent (n=17), refractory (n=4), and intolerant (n=4). ECP treatment protocol was 2 times every 2 weeks or 2 times every 4 weeks. Patients received from 1 to 20 procedures of ECP (median 8).

Results: Complete and partial resolution of cGVHD signs was achieved in 21 pts (84%). The dose of corticosteroid was reduced or stopped in 53% pts. A better response rate was seen in skin (64%), gastro-intestinal tract (61%), oral mucosa (55%) and lung (50%) cGVHD.

Conclusions: ECP is an effective method for treatment of steroid-refractory, steroid-dependent and steroid-intolerant cGVHD.

Keywords: allo-HSCT, cGVHD, extracorporeal photopheresis