Extracorporeal photopheresis in the treatment of acute graft-versus-host disease : a single-center experience

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dc.contributor.author Niittyvuopio, Riitta
dc.contributor.author Juvonen, Eeva
dc.contributor.author Heiskanen, Jouni
dc.contributor.author Lindstrom, Vesa
dc.contributor.author Nihtinen, Anne
dc.contributor.author Sahlstedt, Leila
dc.contributor.author Volin, Liisa
dc.date.accessioned 2019-09-26T21:43:50Z
dc.date.available 2021-12-17T22:02:53Z
dc.date.issued 2018-08
dc.identifier.citation Niittyvuopio , R , Juvonen , E , Heiskanen , J , Lindstrom , V , Nihtinen , A , Sahlstedt , L & Volin , L 2018 , ' Extracorporeal photopheresis in the treatment of acute graft-versus-host disease : a single-center experience ' , Transfusion , vol. 58 , no. 8 , pp. 1973-1979 . https://doi.org/10.1111/trf.14649
dc.identifier.other PURE: 116033752
dc.identifier.other PURE UUID: d898305c-0da8-47b4-b334-240d508e8185
dc.identifier.other WOS: 000444080700039
dc.identifier.other Scopus: 85046015273
dc.identifier.uri http://hdl.handle.net/10138/305621
dc.description.abstract BACKGROUND: Steroid-refractory acute graft-versushost disease (aGVHD) is a serious complication after hematopoietic stem cell transplantation. The long-term outcome of the patients is poor. Various immunosuppressive agents have been proposed as the second-line therapy but none of them has turned out more effective than the others. Extracorporeal photopheresis (ECP) is a treatment option that does not predispose the patients to severe side effects of the immunosuppressive drugs. STUDY DESIGN AND METHODS: We analyzed the treatment results of ECP in 52 patients with steroidrefractory or steroid-dependent aGVHD. Eighty-one percent of the patients suffered from a severe, Grade III or IV, aGVHD. ECP was started alone as the second-line treatment in 23 patients and in combination with an immunosuppressive drug in 18 patients. Eleven patients received ECP as the third-line or later treatment. RESULTS: A total of 62% of the patients responded, with 48% achieving complete response. In the patients with complete or partial response, the probabilities of survival at 4 years were 54 and 17%, respectively. The outcome of nonresponders was poor. The 1-year overall survivals of the patients with ECP as the second-line treatment either alone or in combination with an immunosuppressive drug or as the third-line treatment were 51, 28, and 18%, respectively. In multivariate analysis, starting ECP no later than 10 days after the start of the first-line treatment correlated with a good response and a consequent survival benefit. CONCLUSION: Extracorporeal photopheresis is an effective and well-tolerated treatment that should be considered as a second-line treatment for aGVHD. en
dc.format.extent 7
dc.language.iso eng
dc.relation.ispartof Transfusion
dc.rights unspecified
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject REFRACTORY ACUTE GVHD
dc.subject BONE-MARROW-TRANSPLANTATION
dc.subject 2ND-LINE TREATMENT
dc.subject PEDIATRIC-PATIENTS
dc.subject CLINICAL-EFFICACY
dc.subject DENDRITIC CELLS
dc.subject ITALIAN GROUP
dc.subject PHOTOCHEMOTHERAPY
dc.subject SURVIVAL
dc.subject RECOMMENDATIONS
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.subject 3122 Cancers
dc.title Extracorporeal photopheresis in the treatment of acute graft-versus-host disease : a single-center experience en
dc.type Article
dc.contributor.organization Clinicum
dc.contributor.organization Hematologian yksikkö
dc.contributor.organization Department of Oncology
dc.contributor.organization Department of Medicine
dc.contributor.organization HUS Comprehensive Cancer Center
dc.contributor.organization HUS Internal Medicine and Rehabilitation
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1111/trf.14649
dc.relation.issn 0041-1132
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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