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Background  Extracorporeal photopheresis ( ECP ) has been shown as active therapy for graft‐versus‐host disease ( GVHD ).    Study Design and Methods  The aim was to ascertain the role of  ECP  in 71 patients with steroid‐refractory or ‐dependent acute and chronic  GVHD  ( aGVHD  and  cGVHD ) with special focus on hematologic variables and  GVHD  staging classification. A total of 34 patients were treated for  aGVHD  and 37 for  cGVHD .    Results  The overall response rate ( ORR ) for  aGVHD  was 65% and the complete  aGVHD ‐free survival was 50% (95% confidence interval [ CI ], 36%‐70%). The  ORR  for  cGVHD  response was 81% while the complete  cGVHD ‐free survival was 50% (95%  CI , 34%‐73%). The  aGVHD ‐free survival was associated with  aGVHD  grading ( G rade  II  81%, Grade  III  33%, and Grade  IV  0%, p ≤ 0.00) and the absence of visceral involvement (77% vs. 33%, p = 0.03). The  cGVHD ‐free survival was associated with the female sex (67% vs. 25%, p = 0.01) and with the limited form according to the  S eattle classification (67% vs. 20%, p = 0.003). No role for hematologic values or apheresis cell count was found, except for the  cGVHD ORR  (p = 0.037). Transplant‐related mortality and overall survival were associated with  ECP  response 0% versus 54% (p = 0.0001) and 77% versus 45% (p = 0.03) for  aGVHD  patients and 7% versus 14% (p = 0.02) and 73% versus 20% (p = 0.0003) for  cGVHD  patients, respectively.    Conclusions  While confirming a higher probability of  GVHD  responses for early  GVHD , our study shows no role of hematologic values or apheresis cell count on  GVHD  response.

transfusion

Extracorporeal photopheresis for graft‐versus‐host disease: the role of patient, transplant, and classification criteria and hematologic values on outcome—results from a large single‐center study