Grundmann-Kollmann Marcella, Martin Hans, Ludwig Ralf, Klein Stefan, Boehncke Wolf-Henning, Hoelzer Dieter, Kaufmann Roland, Podda Maurizio
Department of Dermatology, Johann Wolfgang Goethe University, Theodor Stern Kai 7, 60590 Frankfurt, Germany.
Transplantation. 2002 Dec 15;74(11):1631-4. doi: 10.1097/00007890-200212150-00023.
Graft versus host disease (GVHD) is an important problem following allogenic bone marrow transplantation (BMT). The beneficial effects of photochemotherapy with psoralens plus UVA irradiation (PUVA) have been described repeatedly; however, PUVA is limited by a wide range of unwanted effects. A novel improved form of UV-B phototherapy, narrowband UV-B, has been proven to be very effective in T-cell mediated dermatoses. Therefore, we investigated the effect of narrowband UV-B phototherapy (5 times per week) in 10 patients with cutaneous GVHD (grade 2-3) resistant to standard immunosuppressive drugs. It was tolerated well by all patients, and no side effects were observed. Skin lesions showed complete clearance in 7 out of 10 patients within 3 to 5 weeks. 3 patients showed significant improvement of GVHD. We suggest that narrowband UV-B phototherapy is a nonaggressive treatment that may benefit patients with cutaneous GVHD who already take high doses of immunosuppressive drugs.
移植物抗宿主病(GVHD)是异基因骨髓移植(BMT)后的一个重要问题。补骨脂素加紫外线A照射(PUVA)光化学疗法的有益效果已被多次描述;然而,PUVA受到广泛的不良影响的限制。一种新型改良形式的UV-B光疗,即窄谱UV-B,已被证明在T细胞介导的皮肤病中非常有效。因此,我们研究了窄谱UV-B光疗(每周5次)对10例对标准免疫抑制药物耐药的皮肤GVHD(2-3级)患者的疗效。所有患者对其耐受性良好,未观察到副作用。10例患者中有7例在3至5周内皮肤病变完全清除。3例患者的GVHD有显著改善。我们认为窄谱UV-B光疗是一种非侵袭性治疗方法,可能对已经服用高剂量免疫抑制药物的皮肤GVHD患者有益。