Liječnički vjesnik, Vol. 135 No. 5-6, 2013.
Izvorni znanstveni članak
EXTRACORPOREAL PHOTOPHERESIS IN TREATMENT OF CHRONIC GRAFT VERSUS HOST DISEASE
Ines Bojanić
Ranka Serventi Seiwerth
Sanja Mazić
Klara Dubravčić
Drago Batinić
Branka Golubić Ćepulić
Boris Labar
Sažetak
Extracorporeal photopheresis (ECP) is an immunomodulatory therapy which has been used in the treatment of chronic GVHD (cGVHD). ECP involves separation of the mononuclear cells with leukapheresis, followed by ex vivo administration of 8-methoxypsoralen and UV-A radiation and reinfusion to the patient. Aim of the study was to evaluate clinical and immunomodulatory effect of ECP procedures in patients with cGVHD. We analyzed 341 ECP procedures performed in 7 patients with cGVHD; median ECP per patient was 37 (range 13–131). All patients suffered from skin changes in combination with impaired joint mobility and symptoms of oral disease. ECP procedures were performed for two consecutive days: in initial phase weekly, followed by every two weeks and than monthly according to clinical response. Median of ECP treatment duration was 10 months (range 2–58). The effect of ECP in patients with cGVHD with skin and joint involvement was mostly beneficial: 6 patients experienced either improvement or stabilization in skin changes and joint mobility. In 2 patients who suffered from oral disease, the total recovery was observed. Clinical response was typically delayed until 2 to 3 months, and reduction in glucocorticoid dose was observed. Adverse reactions were observed in 4.9% procedures. In patients who responded to ECP treatment, CD4+/CD8+ ratio and number of NK cells were normalized. ECP proved to be an efficient and safe procedure that may be recommended for patients with cGVHD who do not respond to conventional therapy
Ključne riječi
Graft vs host disease – diagnosis, therapy; Photopheresis – methods; Hematopoietic stem cell transplantation – adverse effects; Transplantation, homologous; Immunosuppressive agents – therapeutic use; Chronic disease
Hrčak ID:
172475
URI
Datum izdavanja:
27.6.2013.
Posjeta: 2.885 *