Reschke Robin, Zimmerlich Stephanie, Döhring Christine, Behre Gerhard, Ziemer Mirjana
Department of Pathology, University of Chicago, Chicago, IL 60637, USA.
Department of Dermatology, Venereology and Allergology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 23, D-04103 Leipzig, Germany.
Biomedicines. 2022 Aug 4;10(8):1887. doi: 10.3390/biomedicines10081887.
: Patients with steroid-refractory intestinal acute graft-versus-host disease (aGvHD) and bronchiolitis obliterans syndrome (BOS) represent a population with a high need for alternative and effective treatment options. : We report real-life data from 18 patients treated with extracorporeal photopheresis (ECP). This cohort consisted of nine patients with steroid-refractory intestinal aGvHD and nine patients with BOS. : We document partial or complete clinical response and reduction of symptoms in half of the patients with intestinal acute GvHD and patients with BOS treated ECP. Responding patients tended to stay on treatment longer. In patients with BOS, stabilization of lung function and forced expiratory volume was observed, whereas, less abdominal pain, less diarrhea, and a reduction of systemic corticosteroids were seen in patients with intestinal acute GvHD. : ECP might not only abrogate symptoms but also reduce mortality caused by complications from high-dose steroid treatment. Taken together, ECP offers a serious treatment avenue for patients with steroid-refractory intestinal acute GvHD and BOS.
患有类固醇难治性肠道急性移植物抗宿主病(aGvHD)和闭塞性细支气管炎综合征(BOS)的患者非常需要替代且有效的治疗方案。我们报告了18例接受体外光分离置换法(ECP)治疗患者的实际数据。该队列包括9例类固醇难治性肠道aGvHD患者和9例BOS患者。我们记录了接受ECP治疗的肠道急性移植物抗宿主病患者和BOS患者中有一半出现了部分或完全临床缓解以及症状减轻。有反应的患者往往接受治疗的时间更长。在BOS患者中,观察到肺功能和用力呼气量稳定,而在肠道急性移植物抗宿主病患者中,腹痛减轻、腹泻减少且全身皮质类固醇用量减少。ECP不仅可能消除症状,还可能降低高剂量类固醇治疗并发症导致的死亡率。综上所述,ECP为患有类固醇难治性肠道急性移植物抗宿主病和BOS的患者提供了一种重要的治疗途径。