Extracorporeal photoimmunotherapy for the treatment of steroid refractory progressive chronic graft-versus-host disease

İlhan, Osman; Arat, Mutlu; Arslan, Önder; Ayyildiz, Erol; Şanlı, Hatice; Beksaç, Meral; Özcan, Muhıt; Gürman, Günhan; Akan, Hamdı

doi:10.1016/j.transci.2004.02.003

Cited by 34 publications

(22 citation statements)

References 2 publications

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“…Retrospective studies have indicated that ECP primarily stabilizes BO [21, 22] and is insufficient to render CR in these patients. Recently Lucid et al [22] reported the outcome following ECP use and focused specifically on BO after allo-SCT, which yielded a RR of 67% in 9 patients.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal photopheresis for chronic graft-versus-host disease: a systematic review and meta-analysis

et al. 2014

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BackgroundThe safety of extracorporeal photopheresis (ECP) in steroid-refractory chronic graft-versus-host disease (SR-cGVHD) has been explored in multiple studies but reported response rates (RR) vary significantly across studies.MethodsWe conducted a meta-analysis to assess the efficacy of ECP for SR-cGVHD. A search of electronic databases for studies published between 1984 and 2012 was conducted. End points included RR: complete response (CR), overall response rates (ORR), and organ-specific RR. The initial search generated 312 studies, of which 18 met the selection criteria (N=595). A random effects model was used for pooled rates.ResultsPooled CR rates and ORR were 29% (confidence interval [CI], 19-42%) and 64% (CI, 65-82%), respectively. One-year overall survival was available for 4 studies only and was 49% (CI, 29-70%). The pooled RR for skin, liver, ocular, oral, lung, gastrointestinal and musculoskeletal SR-cGVHD was 74%, 68%, 60%, 72%, 48%, 53%, and 64%, respectively. There was a significant heterogeneity among studies due to differences in ECP schedules and duration. No significant differences in responses to ECP for pediatric and adult populations were found. Sensitivity analysis could not be undertaken due to a limited number of prospective studies.ConclusionECP is an effective therapy for oral, skin, and liver SR-cGVHD, with modest activity in lung and gastrointestinal SR-cGVHD.

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Section: Discussionmentioning

confidence: 99%

Extracorporeal photopheresis for chronic graft-versus-host disease: a systematic review and meta-analysis

et al. 2014

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“…[72][73][74][75][76][77] Data suggest that ECP facilitates a milieu of transplantation tolerance, decreasing effector lymphocyte populations, enriching for regulatory lymphocytes and suppressor antigen-presenting cells. [78][79][80] One study showed benefit for BOS patients with etanercept, which inhibits the tumor necrosis factor receptor, and diminishes ensuing inflammation.…”

Section: 305253mentioning

confidence: 99%

How I treat bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation

Williams

2017

Blood

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In past years, a diagnosis of bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic cell transplant (HCT) conferred nearly universal mortality secondary to lack of consensus for diagnostic criteria, poorly understood disease pathogenesis, and very few studies of therapeutic or supportive care interventions. Recently, however, progress has been made in these areas: revised consensus diagnostic guidelines are now available, supportive care has improved, there is greater understanding of potential mechanisms of disease, and prospective trials are being conducted. This article describes these advances and provides suggestions to optimize therapy for patients with BOS after HCT.

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“…86 Though several studies have been performed in patients with BO after HSCT [61][62][63][64][65][87][88][89][90][91] and lung transplantation, [92][93][94] the studies are difficult to interpret because of the heterogeneity in the treatment schedules, diagnostic criteria and response assessment criteria (Table 1). A prospective randomised study of extracorporeal photopheresis treatment performed by Flowers et al 61 revealed a significant improvement of cGVHD in the skin, and indicated a steroid sparing effect on cGvHD in general.…”

Section: Extracorporeal Photopheresismentioning

confidence: 99%

Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

Uhlving

Buchvald

Heilmann

et al. 2011

Bone Marrow Transplant

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Bronchiolitis obliterans (BO) following allogeneic haematopoietic SCT (HSCT) is a serious complication affecting 1.7-26% of the patients, with a reported mortality rate of 21-100%. It is considered a manifestation of chronic graftversus-host disease, but our knowledge of aetiology and pathogenesis is still limited. Diagnostic criteria are being developed, and will allow more uniform and comparable research activities between centres. At present, no randomised controlled trials have been completed that could demonstrate an effective treatment. Steroids in combination with other immunosuppressive drugs still constitute the backbone of the treatment strategy, and results from our and other centres suggest that monthly infusions of high-dose pulse i.v. methylprednisolone (HDPM) might stabilise the disease and hinder progression. This article provides an overview of the current evidence regarding treatment options for BO and presents the treatment results with HDPM in a paediatric national HSCT-cohort.

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Extracorporeal photoimmunotherapy for the treatment of steroid refractory progressive chronic graft-versus-host disease

Cited by 34 publications

References 2 publications

Extracorporeal photopheresis for chronic graft-versus-host disease: a systematic review and meta-analysis

Extracorporeal photopheresis for chronic graft-versus-host disease: a systematic review and meta-analysis

How I treat bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation

Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

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