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Extracorporeal photochemotherapy for paediatric patients with graft‐versus‐host disease after haematopoietic stem cell transplantation
Author(s) -
Messina Chiara,
Locatelli Franco,
Lanino Edoardo,
Uderzo Cornelio,
Zacchello Graziella,
Cesaro Simone,
Pillon Marta,
Perotti Cesare,
Del Fante Claudia,
Faraci Maura,
Rivabella Lucia,
Calore Elisabetta,
De Stefano Pietro,
Zecca Marco,
Giorgiani Giovanna,
Brugiolo Alessandra,
Balduzzi Adriana,
Dini Giorgio,
Zanesco Luigi,
Dall'Amico Roberto
Publication year - 2003
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2003.04401.x
Subject(s) - medicine , graft versus host disease , extracorporeal photopheresis , refractory (planetary science) , hematopoietic stem cell transplantation , transplantation , photopheresis , gastroenterology , disease , surgery , immunology , physics , astrobiology
Summary. This study aimed to ascertain whether extracorporeal photochemotherapy (ECP) is an effective treatment for paediatric patients with refractory graft‐versus‐host disease (GVHD). From January 1992 to December 2000, 77 children (median age 8·6 years) with either acute ( n = 33) or chronic ( n = 44) GVHD, resistant to conventional immunosuppressive therapy, were treated with ECP in four Italian paediatric hospitals. After ECP, acute GVHD involving skin, liver and gut responded completely in 76%, 60% and 75% of patients respectively. The 5‐year overall survival was 69% for responding patients vs 12% for non‐responders ( P = 0·001). Among the 44 children with chronic GVHD, 15 (44%) showed a complete response and 10 (29%) a significant improvement after ECP. The 5‐year overall survival was 96% for responders vs 58% for non‐responders ( P = 0·04). Our results suggest that ECP is an effective treatment that may be useful in paediatric patients with either acute or chronic GVHD who have failed to respond to standard immunosuppressive therapy.