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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
9
|
| pubmed:dateCreated |
1998-11-30
|
| pubmed:abstractText |
Extracorporeal exposure of peripheral blood mononuclear cells to the photosensitizing compound 8-methoxypsoralen and ultraviolet A radiation has been shown to be effective in the treatment of several T-cell-mediated diseases, including cutaneous T-cell lymphoma and rejection after organ transplantation. We present 21 patients (10 men and 11 women) with hematological malignancies with a median age of 36 years (range, 25 to 55 years) who had received marrow grafts from sibling (n = 12) or unrelated (n = 9) donors. Six patients had acute graft-versus-host disease (GVHD) grade II to III not responding to cyclosporine A (CSA) and prednisolone when referred to extracorporeal photochemotherapy (ECP). In 15 patients, 2 to 24 months after bone marrow transplantation (BMT), extensive chronic GVHD with involvement of skin (n = 15), liver (n = 10), oral mucosa (n = 11), ocular glands (n = 6), and thrombocytopenia (n = 3) developed and was unresponsive to conventional therapy, including steroids. All patients were treated with ECP on 2 consecutive days every 2 weeks for the first 3 months and thereafter every 4 weeks until resolution of GVHD. ECP was tolerated excellently without any significant side effects. After a median of 14 cycles of ECP, acute GVHD resolved completely in 4 of 6 patients (67%) and partially in another 2 patients. Cutaneous chronic GVHD completely resolved in 12 of 15 (80%) patients. Contractures of knees and elbows due to scleroderma resolved partially. Oral mucosal ulcerations resolved in all patients. Seven of 10 patients (70%) with liver involvement had complete responses after ECP. After discontinuation of ECP, no severe infections were observed. Our findings suggest that ECP is a safe and effective adjunct therapy for both acute and extensive chronic GVHD with skin and visceral involvement and resistance to conventional therapy.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
AIM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Nov
|
| pubmed:issn |
0006-4971
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| pubmed:author | |
| pubmed:copyrightInfo |
Copyright 1998 by The American Society of Hematology
|
| pubmed:issnType |
Print
|
| pubmed:day |
1
|
| pubmed:volume |
92
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
3098-104
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:9787144-Acute Disease,
pubmed-meshheading:9787144-Adult,
pubmed-meshheading:9787144-Anemia, Aplastic,
pubmed-meshheading:9787144-Bone Marrow Transplantation,
pubmed-meshheading:9787144-Chronic Disease,
pubmed-meshheading:9787144-Female,
pubmed-meshheading:9787144-Graft vs Host Disease,
pubmed-meshheading:9787144-Hematologic Neoplasms,
pubmed-meshheading:9787144-Humans,
pubmed-meshheading:9787144-Immunosuppression,
pubmed-meshheading:9787144-Infection,
pubmed-meshheading:9787144-Life Tables,
pubmed-meshheading:9787144-Male,
pubmed-meshheading:9787144-Middle Aged,
pubmed-meshheading:9787144-Photopheresis,
pubmed-meshheading:9787144-Skin,
pubmed-meshheading:9787144-Survival Analysis,
pubmed-meshheading:9787144-Treatment Outcome
|
| pubmed:year |
1998
|
| pubmed:articleTitle |
Successful use of extracorporeal photochemotherapy in the treatment of severe acute and chronic graft-versus-host disease.
|
| pubmed:affiliation |
Department of Medicine I, Bone Marrow Transplantation Unit, University of Vienna, Austria.
|
| pubmed:publicationType |
Journal Article
|