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欧洲皮肤病学论坛:2020年体外光化学疗法使用的更新指南 - 第2部分

European dermatology forum: Updated guidelines on the use of extracorporeal photopheresis 2020 - Part 2.

作者信息

Knobler R, Arenberger P, Arun A, Assaf C, Bagot M, Berlin G, Bohbot A, Calzavara-Pinton P, Child F, Cho A, French L E, Gennery A R, Gniadecki R, Gollnick H P M, Guenova E, Jaksch P, Jantschitsch C, Klemke C, Ludvigsson J, Papadavid E, Scarisbrick J, Schwarz T, Stadler R, Wolf P, Zic J, Zouboulis C, Zuckermann A, Greinix H

机构信息

Department of Dermatology, Medical University of Vienna, Vienna, Austria.

Third Faculty of Medicine, Charles University, Prague, Czech Republic.

出版信息

J Eur Acad Dermatol Venereol. 2021 Jan;35(1):27-49. doi: 10.1111/jdv.16889. Epub 2020 Sep 22.

Abstract

BACKGROUND

Following the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma published in 1983, this technology has received continued use and further recognition for additional earlier as well as refractory forms. After the publication of the first guidelines for this technology in the JEADV in 2014, this technology has maintained additional promise in the treatment of other severe and refractory conditions in a multidisciplinary setting. It has confirmed recognition in well-known documented conditions such as graft-vs.-host disease after allogeneic bone marrow transplantation, systemic sclerosis, solid organ transplant rejection including lung, heart and liver and to a lesser extent inflammatory bowel disease.

MATERIALS AND METHODS

In order to further provide recognized expert practical guidelines for the use of this technology for all indications, the European Dermatology Forum (EDF) again proceeded to address these questions in the hands of the recognized experts within and outside the field of dermatology. This was done using the recognized and approved guidelines of EDF for this task. All authors had the opportunity to review each contribution as it was added.

RESULTS AND CONCLUSION

These updated 2020 guidelines provide at present the most comprehensive available expert recommendations for the use of extracorporeal photopheresis based on the available published literature and expert consensus opinion. The guidelines were divided into two parts: PART I covers Cutaneous T-cell lymphoma, chronic graft-vs.-host disease and acute graft-vs.-host disease, while PART II will cover scleroderma, solid organ transplantation, Crohn's disease, use of ECP in paediatric patients, atopic dermatitis, type 1 diabetes, pemphigus, epidermolysis bullosa acquisita and erosive oral lichen planus.

摘要

背景

1983年发表了关于使用体外光化学疗法治疗皮肤T细胞淋巴瘤的第一项研究性研究后,该技术持续得到应用,并在更多早期以及难治性病例中获得了进一步认可。2014年《欧洲皮肤病学与性病学杂志》(JEADV)发表了该技术的首个指南后,该技术在多学科环境中治疗其他严重和难治性疾病方面仍具有更大潜力。它在一些著名的已记录疾病中得到了认可,如异基因骨髓移植后的移植物抗宿主病、系统性硬化症、包括肺、心脏和肝脏在内的实体器官移植排斥反应,以及在较小程度上的炎症性肠病。

材料与方法

为了进一步为该技术在所有适应症中的应用提供公认的专家实用指南,欧洲皮肤病学论坛(EDF)再次请皮肤病学领域内外的知名专家来解决这些问题。这是按照EDF为此任务认可和批准的指南进行的。所有作者都有机会在每篇稿件添加时进行审阅。

结果与结论

这些2020年更新的指南目前基于已发表的文献和专家共识意见,提供了关于使用体外光化学疗法最全面的现有专家建议。指南分为两部分:第一部分涵盖皮肤T细胞淋巴瘤、慢性移植物抗宿主病和急性移植物抗宿主病,而第二部分将涵盖硬皮病、实体器官移植、克罗恩病、儿科患者使用体外循环光化学疗法、特应性皮炎、1型糖尿病、天疱疮、获得性大疱性表皮松解症和糜烂性口腔扁平苔藓。

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