Document Detail


Extracorporeal photochemotherapy for treatment of acute and chronic GVHD in childhood.
MedLine Citation:
PMID:  11606832     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Extracorporeal photochemotherapy (EPC) has recently been proposed for the treatment of adults with either acute or chronic GVHD. However, data on children given this therapy are scarce. A Phase I-II study was carried out on EPC in children experiencing GVHD after allogeneic transplantation of HPCs. STUDY DESIGN AND METHODS: Nine patients with steroid-resistant, grade II-IV acute GVHD and 14 with chronic GVHD, all of whom had been refractory to at least one line of treatment, were enrolled in this study and analyzed. The median age was 10.3 years (range, 5.4-18.1), and the median body weight was 35 kg (range, 17-89). RESULTS: Seven of the nine patients with acute GVHD showed a response to EPC, whereas the disease progressed in the remaining two children (both with skin, gastrointestinal, and liver GVHD), and they died of grade IV acute GVHD. Among the seven children who responded to EPC, it was possible to completely discontinue immunosuppressive treatment in three. In the 14 children with chronic GVHD, 4 and 5 patients experienced complete and partial response to EPC, respectively, whereas the remaining 5 patients, all with extensive chronic GVHD, had stable disease or disease that progressed during EPC. Among these latter 5 patients, 3 died. In 6 of the 9 patients with chronic GVHD responding to EPC, immunosuppressive therapy was discontinued. CONCLUSION: EPC is safe, feasible, and effective in children with either acute or chronic GVHD occurring after an allograft.
Authors:
L Salvaneschi; C Perotti; M Zecca; S Bernuzzi; G Viarengo; G Giorgiani; C Del Fante; P Bergamaschi; R Maccario; A Pession; F Locatelli
Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transfusion     Volume:  41     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-18     Completed Date:  2001-12-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1299-305     Citation Subset:  IM    
Affiliation:
Immunohematology and Transfusion Service, Center for Transplant Immunology, and the Pediatric Hematology-Oncology Division, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy. c.perotti@smatteo.pv.it
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Child
Child, Preschool
Chronic Disease
Drug Resistance
Graft vs Host Disease / mortality,  therapy*
Hematopoietic Stem Cell Transplantation / adverse effects
Humans
Photopheresis / standards*
Prospective Studies
Steroids
Survival Rate
Transplantation, Homologous / adverse effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Steroids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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