Wiesmann A, Weller A, Lischka G, Klingebiel T, Kanz L, Einsele H
Department of Hematology and Oncology, University of Tübingen, Germany.
Bone Marrow Transplant. 1999 Jan;23(2):151-5. doi: 10.1038/sj.bmt.1701537.
Acute graft-versus-host disease (aGVHD) is a frequent and major complication after allogeneic stem cell transplantation. For many years psoralen and ultraviolet (UV)-A light have been used in the treatment of chronic cutaneous graft-versus-host disease, but few patients have received PUVA therapy for aGVHD. We assessed 20 patients who received PUVA therapy for acute cutaneous GVHD (grade 2-4). Seven patients showed additional organ manifestations (liver, gut). To better quantify the cutaneous lesions, a new scoring system was introduced: intensity of erythema (0-3) x %body surface + size of bullae (4-5) x %body surface affected. All patients received prednisolone and PUVA for treatment of aGVHD. Fifteen patients (75%), 12 with manifestations restricted to the skin, responded by score classification (average time to a 50% score reduction: 39 days) and reduction of the dosage of prednisolone (average time to a 50% prednisolone reduction: 35 days). PUVA treatment was well tolerated and might play a role in the therapy of acute cutaneous GVHD.
急性移植物抗宿主病（aGVHD）是异基因干细胞移植后常见的主要并发症。多年来，补骨脂素和紫外线A光一直用于治疗慢性皮肤移植物抗宿主病，但很少有患者接受PUVA疗法治疗aGVHD。我们评估了20例接受PUVA疗法治疗急性皮肤GVHD（2-4级）的患者。7例患者出现了其他器官表现（肝脏、肠道）。为了更好地量化皮肤病变，引入了一种新的评分系统：红斑强度（0-3）×体表面积百分比 + 水疱大小（4-5）×受影响体表面积百分比。所有患者均接受泼尼松龙和PUVA治疗aGVHD。15例患者（75%），其中12例表现局限于皮肤，通过评分分类（评分降低50%的平均时间：39天）和泼尼松龙剂量减少（泼尼松龙减少50%的平均时间：35天）获得缓解。PUVA治疗耐受性良好，可能在急性皮肤GVHD的治疗中发挥作用。
