Gerber M, Gmeinhart B, Volc-Platzer B, Kalhs P, Greinix H, Knobler R
Department of Dermatology, University of Vienna, Austria.
Bone Marrow Transplant. 1997 Mar;19(5):517-9. doi: 10.1038/sj.bmt.1700661.
A 45-year-old female patient with CML underwent allogeneic BMT and developed two episodes of acute GVHD. The first episode of acute cutaneous GVHD grade II (day +17) responded well to systemic CsA and steroids. During the second episode (around day +60) the patient developed erythroderma (grade III), and subsequently signs of lichen-planus-like GVHD. The patient did not respond to increased dosages of prednisolone and CsA. On day +89 extracorporeal photochemotherapy (ECP) was initiated. After four cycles, a significant improvement of erythroderma and lichen-planus-like lesions was documented, and after 12 cycles, a lasting complete remission was achieved. To our knowledge this is the first report of successful treatment of early-onset, lichen-planus-like GVHD after allogeneic BMT with ECP.
一名45岁的慢性粒细胞白血病女性患者接受了异基因骨髓移植,并发生了两次急性移植物抗宿主病。急性皮肤移植物抗宿主病的首次发作(II级,+17天)对全身使用环孢素和类固醇反应良好。在第二次发作期间(约+60天),患者出现红皮病(III级),随后出现扁平苔藓样移植物抗宿主病的体征。患者对增加剂量的泼尼松龙和环孢素无反应。在+89天开始进行体外光化学疗法(ECP)。四个疗程后,记录到红皮病和扁平苔藓样病变有显著改善,12个疗程后实现了持久的完全缓解。据我们所知,这是首例关于异基因骨髓移植后早期扁平苔藓样移植物抗宿主病采用ECP成功治疗的报告。