Reinauer S, Lehmann P, Plewig G, Heyll A, Söhngen D, Hölzle E
Hautklinik, Heinrich-Heine-Universität Düsseldorf.
Hautarzt. 1993 Nov;44(11):708-12.
For several years, psoralen and UV-A light (PUVA) therapy has been used in the treatment of chronic graft-versus-host disease (GvHD) following allogeneic bone marrow transplantation (BMT). There is little experience with PUVA treatment of acute GvHD. Allogeneic BMT was performed in 25 patients, 10 of whom developed acute GvHD despite immunosuppressive therapy. Six patients with acute cutaneous GvHD grade II-III (n = 2 grade II, n = 4 grade III) were treated with PUVA. We present the results. All the PUVA-treated patients improved markedly after 5-12 sessions of irradiation. In 5 patients the skin cleared completely with 8-18 treatments. In 4 patients chronic GvHD was prevented by maintenance treatment for up to 10 months. Following clearing of acute cutaneous GvHD, 2 patients developed chronic GvHD after therapy-free intervals of 3 and 12 months, respectively. These results indicate a beneficial effect of PUVA in acute cutaneous GvHD and suggest a protective effect against chronic GvHD.
数年来，补骨脂素与紫外线A光（PUVA）疗法一直用于治疗异基因骨髓移植（BMT）后的慢性移植物抗宿主病（GvHD）。PUVA治疗急性GvHD的经验很少。对25例患者进行了异基因BMT，其中10例尽管接受了免疫抑制治疗仍发生了急性GvHD。对6例急性皮肤Ⅱ-Ⅲ级GvHD患者（2例Ⅱ级，4例Ⅲ级）进行了PUVA治疗。我们展示了结果。所有接受PUVA治疗的患者在5至12次照射后均有明显改善。5例患者经8至18次治疗后皮肤完全清除。4例患者通过长达10个月的维持治疗预防了慢性GvHD。急性皮肤GvHD清除后，2例患者分别在3个月和12个月的无治疗间隔期后发生了慢性GvHD。这些结果表明PUVA对急性皮肤GvHD有有益作用，并提示对慢性GvHD有保护作用。
