Steroid-Sparing Effect of Extracorporeal Photopheresis in the Treatment of Graft-vs-Host Disease

Coyle, T.; Nam, Teresa K.; Camouse, Melissa; Stevens, Seth R.; Baron, Elma D.

doi:10.1001/archderm.140.6.763

Cited by 6 publications

(2 citation statements)

References 5 publications

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“…Although clinical response is of major interest, it is equally important to emphasize the steroid‐sparing response, especially in young patients who are particularly susceptible to the side effects of steroids. In agreement with other reports, 13,18,30 we found that once ECP is started, the gradual improvement allowed us to either reduce (9/19, 47%) or stop (10/19, 52%) concomitant therapy in all 19 responders. Our feeling is that more importance should be given to sparing steroids and thus to the role of ECP in pediatric patients.…”

Section: Discussionsupporting

confidence: 92%

Photopheresis in pediatric graft‐versus‐host disease after allogeneic marrow transplantation: clinical practice guidelines based on field experience and review of the literature

Kanold¹,

Merlin²,

Hallé

et al. 2007

Transfusion

106

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A specifically pediatric-dedicated and -experienced team faces only limited difficulties when treating children with GVHD by ECP. Overall, ECP is efficient and well tolerated. Our experience was therefore pooled together with available pediatric data to establish clinical practice guidelines. These guidelines consider ECP as a first-line therapy in Grade IV aGVHD (in association with conventional pharmacologic approaches) and limited cGVHD and as a second-line therapy in steroid-resistant Grades II to III aGVHD and extensive cGVHD.

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Section: Discussionsupporting

confidence: 92%

Photopheresis in pediatric graft‐versus‐host disease after allogeneic marrow transplantation: clinical practice guidelines based on field experience and review of the literature

Kanold¹,

Merlin²,

Hallé

et al. 2007

Transfusion

106

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“…Other authors quote a cutaneous response rate of approximately 75%, with 35% achieving complete clearance 11 . Treatment with ECP may convey a steroid‐sparing effect, with consequently lower morbidity 33 . There is hence some evidence to support the use of ECP in chronic GVHD; 34 however, there is a paucity of evidence specifically regarding sclerodermatous GVHD.…”

Section: Discussionmentioning

confidence: 99%

Sclerodermatous graft-versus-host disease: clinical spectrum and therapeutic challenges

White¹,

Creamer²,

Vivier³

et al. 2007

Br J Dermatol

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Sclerodermatous graft-versus-host disease (GVHD) is a rare complication of bone marrow transplantation. While GVHD is often associated with the beneficial graft vs. tumour effect, it also contributes towards significant morbidity and mortality. No reliably effective treatment has yet been established. We present 10 patients with haematological malignancies who underwent an allogeneic stem cell transplant and developed sclerodermatous GVHD. Donor lymphocyte infusion administered for relapse or reducing donor T-cell chimerism was a known trigger for sclerodermatous GVHD in four of the patients. Treatment with immunosuppressants, psoralen plus ultraviolet A (PUVA) and extracorporeal photopheresis has been largely unsuccessful in their management. Intensive immunosuppression including the use of anti-CD20 monoclonal antibody may have contributed to relapse of leukaemia in one patient 10 years after her transplant. Sclerodermatous GVHD may occur without a preceding lichenoid stage. Clinical heterogeneity is common, although sclerodermatous GVHD has a predilection for the limbs. Treatment options are largely unsatisfactory if conventional immunosuppression fails. PUVA may give some symptomatic benefit and extracorporeal photopheresis seems to be less efficacious than previously published work suggests.

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Guidelines on the Use of Therapeutic Apheresis in Clinical Practice—Evidence‐Based Approach from the Writing Committee of the American Society for Apheresis: The Sixth Special Issue

Schwartz

Winters

Padmanabhan

et al. 2013

J of Clinical Apheresis

556

769

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The American Society for Apheresis (ASFA) JCA Special Issue Writing Committee is charged with reviewing, updating and categorizating indications for therapeutic apheresis. Beginning with the 2007 ASFA Special Issue (Fourth Edition), the committee has incorporated systematic review and evidence-based approach in the grading and categorization of indications. This Sixth Edition of the ASFA Special Issue has further improved the process of using evidence-based medicine in the recommendations by consistently applying the category and GRADE system definitions, but eliminating the "level of evidence" criteria (from the University HealthCare Consortium) utilized in prior editions given redundancy between GRADE and University HealthCare Consortium systems. The general layout and concept of a fact sheet that was utilized in the Fourth and Fifth Editions, has been largely maintained in this edition. Each fact sheet succinctly summarizes the evidence for the use of therapeutic apheresis in a specific disease entity. This article consists of 78 fact sheets (increased from 2010) for therapeutic indications in ASFA categories I through IV, with many diseases categorized having multiple clinical presentations/situations which are individually graded and categorized.

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Steroid-Sparing Effect of Extracorporeal Photopheresis in the Treatment of Graft-vs-Host Disease

Cited by 6 publications

References 5 publications

Photopheresis in pediatric graft‐versus‐host disease after allogeneic marrow transplantation: clinical practice guidelines based on field experience and review of the literature

Photopheresis in pediatric graft‐versus‐host disease after allogeneic marrow transplantation: clinical practice guidelines based on field experience and review of the literature

Sclerodermatous graft-versus-host disease: clinical spectrum and therapeutic challenges

Guidelines on the Use of Therapeutic Apheresis in Clinical Practice—Evidence‐Based Approach from the Writing Committee of the American Society for Apheresis: The Sixth Special Issue

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