Extracorporeal photopheresis for acute and chronic graft-versus-host disease: Does it work?

Daniel Couriel, Chitra Hosing, Rima Saliba, Elizabeth J. Shpall, Paolo Andelini, Uday Popat, Michele Donato, Richard Champlin

Research output: Contribution to journalReview articlepeer-review

72 Scopus citations

Abstract

Acute and chronic graft-versus-host disease (GVHD) continue to be major limitations to successful hematopoietic stem cell transplantation. A variety of different immunosuppressive and immunomodulating modalities have been tested in chronic GVHD, among them extracorporeal photopheresis. Photopheresis is currently indicated and Food and Drug Administration-approved for the treatment of skin manifestations of cutaneous T-cell lymphoma, where the response rate has proved to be considerably high. Extracorporeal photochemotherapy has been evaluated in small cohorts of patients with both acute and chronic GVHD. In steroid-refractory acute GVHD of the skin and liver, the reported response rate is more than 60%, especially in patients with less severe forms of the disease. There is more extensive experience in the treatment of chronic GVHD; overall response rates of 50% and higher have been reported in patients with skin, oral, eye, liver, gastrointestinal, or lung involvement. At our center, we analyzed 63 patients who had 3 or fewer lines of immunosuppressant, including tacrolimus and steroids, to avoid the confounding effects of numerous immunosuppressive therapies. The overall response rate was 59% (n = 37), and complete responses were seen in 13 patients. The best responses were observed in GVHD of the skin, liver, oral mucosa, and eye. Our results in chronic GVHD support previous reports of objective responses of skin and visceral GVHD to extracorporeal photopheresis. All of these results indicate activity of extracorporeal photopheresis in acute and chronic GVHD, which warrants further evaluation of this therapy in well-designed, prospective, controlled studies.

Original languageEnglish (US)
Pages (from-to)37-40
Number of pages4
JournalBiology of Blood and Marrow Transplantation
Volume12
Issue number1 SUPPL. 2
DOIs
StatePublished - Jan 2006

Keywords

  • Bone marrow transplantation
  • Graft versus host disease
  • Photopheresis

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Fingerprint

Dive into the research topics of 'Extracorporeal photopheresis for acute and chronic graft-versus-host disease: Does it work?'. Together they form a unique fingerprint.

Cite this