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Prepublished online as a Blood First Edition Paper on April 24, 2003; DOI 10.1182/blood-2002-11-3351. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-11-3351v1 102/4/1217    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Seaton, E. D. Articles by Russell-Jones, R. Search for Related Content PubMed PubMed Citation Articles by Seaton, E. D. Articles by Russell-Jones, R. Related Collections Neoplasia Transplantation Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 August 2003, Vol. 102, No. 4, pp. 1217-1223 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Influence of extracorporeal photopheresis on clinical and laboratory parameters in chronic graft-versus-host disease and analysis of predictors of response Edward D. Seaton, Richard M. Szydlo, Edward Kanfer, Jane F. Apperley, and Robin Russell-Jones From St John's Institute of Dermatology, St Thomas' Hospital, London, England; and the Departments of Haematology and Dermatology, Hammersmith Hospital Campus, Imperial College, London, England. We report 28 patients with advanced chronic graft-versus-host disease (cGVHD) treated with extracorporeal photopheresis (ECP). All had failed conventional immunosuppressive therapy. Of the patients, 27 had extensive cGVHD and 20 had more than 50% cutaneous surface area involvement. ECP was initiated approximately 2 years after onset of cGVHD and 3 years following allogeneic stem cell transplantation and administered fortnightly for 4 months and then monthly. Response was assessed using quantifiable disease measures, including skin score, liver function tests (LFTs), blood counts, and lung function tests. Regression analysis allowed assessment of any pretreatment clinical or laboratory parameters that predicted response. There were 25 patients who completed 3 months and 21 who completed 6 months of treatment. Systemic immunosuppression was stable or reduced in 86% of patients. There were 3 patients who died from cGVHD. After 6 months, median skin scores were 53% lower (P = .003) in sclerodermoid and lichenoid disease. Of 6 patients with mucosal ulceration, 3 improved. A nonsignificant improvement of LFTs occurred. We infer that ECP is effective even in patients with extensive cutaneous cGVHD of 2 years duration that is resistant to conventional therapy. Furthermore, both sclerodermoid and lichenoid subtypes responded. However, no baseline parameters predicted a favorable response to ECP, so patient selection must continue to be made on clinical grounds. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Chronic graft-versus-host disease (cGVHD) is more frequent due to changes in the practice of stem cell transplantation (SCT) Georgia B. Vogelsang Blood 2003 102: 1149-1150. [Full Text] [PDF] This article has been cited by other articles: D. R. Couriel, C. Hosing, R. Saliba, E. J. Shpall, P. Anderlini, B. Rhodes, V. Smith, I. Khouri, S. Giralt, M. de Lima, et al. Extracorporeal photochemotherapy for the treatment of steroid-resistant chronic GVHD Blood, April 15, 2006; 107(8): 3074 - 3080. [Abstract] [Full Text] [PDF]

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