Vogelsang G B, Wolff D, Altomonte V, Farmer E, Morison W L, Corio R, Horn T
Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bone Marrow Transplant. 1996 Jun;17(6):1061-7.
Chronic graft-versus-host disease (GVHD) remains a difficult clinical problem to treat and manage. We have reviewed our treatment of 40 patients treated at a single institution with PUVA (ultraviolet irradiation and psoralen) over a 14 year period. Thirty-five patients were treated for refractory chronic GVHD and five patients were treated at presentation of high-risk chronic GVHD. Overall, 31 of 40 patients improved on PUVA treatment. Sixteen patients achieved a complete response to PUVA added to their GVHD regimen. Four of the 15 partial responders had complete resolution of cutaneous GVHD but persistence of other systemic manifestations. The remaining partial responders had at least a 50% improvement in GVHD. We have also used PUVA with a glass fiber extension to treat intra-oral GVHD. PUVA is well tolerated with a high rate of response in the skin and mild side effects except for three patients who had therapy discontinued after phototoxicity (burn).
慢性移植物抗宿主病（GVHD）仍然是一个难以治疗和管理的临床问题。我们回顾了在一家机构中，14年间接受补骨脂素紫外线照射疗法（PUVA）治疗的40例患者的治疗情况。35例患者接受了难治性慢性GVHD的治疗，5例患者在出现高危慢性GVHD时接受了治疗。总体而言，40例患者中有31例在接受PUVA治疗后病情有所改善。16例患者在GVHD治疗方案中加入PUVA后实现了完全缓解。15例部分缓解者中有4例皮肤GVHD完全消退，但其他全身表现持续存在。其余部分缓解者的GVHD至少改善了50%。我们还使用了带有玻璃纤维延长装置的PUVA来治疗口腔内GVHD。PUVA耐受性良好，皮肤反应率高，副作用轻微，只有3例患者在出现光毒性（烧伤）后停止了治疗。
