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Narrow‐band UVB phototherapy for management of oral chronic graft‐versus‐host disease
Author(s) -
Treister Nathaniel,
Li Shuli,
Lerman Mark A,
Lee Stephanie,
Soiffer Robert
Publication year - 2015
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1111/phpp.12141
Subject(s) - medicine , erythema , refractory (planetary science) , graft versus host disease , complication , toxicity , hematopoietic stem cell transplantation , dermatology , transplantation , surgery , physics , astrobiology
Objectives Oral chronic graft‐versus‐host disease (c GVHD ) is a debilitating complication following allogeneic hematopoietic cell transplantation. The objective of this study was to evaluate the safety and efficacy of intraoral narrow‐band ultraviolet B ( NB‐UVB ) phototherapy in the management of oral c GVHD . Methods Patients with oral c GVHD were treated using a custom NB‐UVB unit for a course of 24 phototherapy sessions. Treatments were initiated at 50 mJ/cm 2 and increased by 10% at each visit unless toxicity was noted. Toxicity and response were assessed weekly. Results Eleven patients received a median of 22 (range 4–39) NB‐UVB treatments; 5 patients completed 24 treatments and elected to receive a median of 7 additional treatments. Median symptom scores (0–10) for sensitivity, pain, and dryness at baseline/end of therapy were 7.5, 3, 1, and 3, 1, 2, respectively. Taking into account all patient‐reported outcomes, 7/11 patients had improvement and 2/11 worsened. At least partial improvement was reported in 8/11 patients with none reporting worsening. Overtreatment occurred in 10/11 patients with all graded mild or moderate and resolving in 1–2 days. Conclusions Intraoral NB‐UVB may be effective for management of refractory oral cGVHD . Further optimization of treatment parameters, as well as minimal erythema dose testing, and inclusion of a control arm are necessary in the consideration of future studies.