Del Fante Claudia, Perotti Cesare
Immunohaematology and Transfusion Service, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Italy.
Transfus Apher Sci. 2017 Feb;56(1):17-19. doi: 10.1016/j.transci.2016.12.010. Epub 2017 Jan 13.
Bronchiolitis obliterans syndrome (BOS) is the main manifestation of pulmonary GVHD. It has often a dramatic and fast evolution and current treatment (change or increase in immunosuppression, macrolides and inhaled therapy) is poor with high mortality rates. In this scenario, extracorporeal photopheresis (ECP) bursts as a new immunomodulatory approach with a different philosophical purpose. In fact, available data show that ECP treatment is intended to delay the inflammatory process and consequently respiratory lung function decline, rather than reverse the damage itself. Preliminary results reported in literature show that ECP may effectively improve/slow lung function decline in cGVHD patients with BOS after standard treatment failure. Further studies are needed to confirm the efficacy of ECP, assess the optimal schedule and consider it for early treatment.
闭塞性细支气管炎综合征（BOS）是肺部移植物抗宿主病（GVHD）的主要表现。它通常发展迅速且病情严重，目前的治疗方法（改变或增加免疫抑制、使用大环内酯类药物和吸入疗法）效果不佳，死亡率很高。在这种情况下，体外光化学疗法（ECP）作为一种具有不同理念目的的新型免疫调节方法应运而生。事实上，现有数据表明，ECP治疗旨在延缓炎症进程，从而延缓呼吸肺功能下降，而非逆转损伤本身。文献报道的初步结果显示，在标准治疗失败后，ECP可有效改善/延缓患有BOS的慢性GVHD患者的肺功能下降。需要进一步研究以证实ECP的疗效，评估最佳治疗方案，并考虑将其用于早期治疗。
