Department of Hematology and Internal Oncology, University of Regensburg, Regensburg, Germany.
Bone Marrow Transplant. 2013 Mar;48(3):439-45. doi: 10.1038/bmt.2012.156. Epub 2012 Aug 27.
In this retrospective analysis, 30 patients with acute GVHD (aGVHD) and 32 patients with chronic GVHD (cGVHD) treated with extracorporeal photopheresis (ECP) performed by the COBE Spectra System were evaluated. After 3 months of ECP treatment, a CR and PR were observed in 9 (30%) and 6 (20%) patients with aGVHD and in 2 (6%) and 12 (38%) patients with cGVHD. In 16 (53%) patients with aGVHD and 9 (28%) with cGVHD ECP treatment was already stopped after 3 months. One (3%) patient with aGVHD and 7 (22%) patients with cGVHD received new additional immunosuppressive therapy started during the first 3 months of ECP treatment and were classified as 'nonresponder' with regard to ECP. Of these patients a PR was achieved in one patient with aGVHD and in three patients with cGVHD. Steroids could be tapered by 50 in 83% of patients with aGVHD and in 29% of patients with cGVHD after 3 months of ECP treatment. Patients with aGVHD achieving a CR or PR showed a significant improved OS after allo-SCT (P=0.019). ECP is associated with significant response rates and successful reduction of steroids in patients with GVHD.
在这项回顾性分析中,评估了 30 例急性移植物抗宿主病(aGVHD)和 32 例慢性移植物抗宿主病(cGVHD)患者接受 COBE Spectra 系统进行的体外光化学疗法(ECP)治疗。在 ECP 治疗 3 个月后,aGVHD 患者中 9 例(30%)和 6 例(20%)达到完全缓解(CR)和部分缓解(PR),cGVHD 患者中 2 例(6%)和 12 例(38%)达到 CR 和 PR。在 16 例(53%)aGVHD 患者和 9 例(28%)cGVHD 患者中,在 3 个月后已经停止 ECP 治疗。1 例(3%)aGVHD 患者和 7 例(22%)cGVHD 患者在 ECP 治疗的前 3 个月内接受了新的额外免疫抑制治疗,并被归类为 ECP 无反应者。这些患者中,1 例 aGVHD 患者和 3 例 cGVHD 患者获得 PR。在 ECP 治疗 3 个月后,83%的 aGVHD 患者和 29%的 cGVHD 患者可以将类固醇减少 50%。在 allo-SCT 后,达到 CR 或 PR 的 aGVHD 患者的 OS 显著改善(P=0.019)。ECP 与 GVHD 患者的显著反应率和类固醇成功减量相关。