Effective Extracorporeal Photopheresis of Patients with Transplantation Induced Acute Intestinal GvHD and Bronchiolitis Obliterans Syndrome

Background: Patients with steroid-refractory intestinal acute graft-versus-host disease (aGvHD) and bronchiolitis obliterans syndrome (BOS) represent a population with a high need for alternative and effective treatment options. Methods: We report real-life data from 18 patients treated with extraco...

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Bibliographic Details
Published in:Biomedicines 2022-08, Vol.10 (8), p.1887
Main Authors: Reschke, Robin, Zimmerlich, Stephanie, Döhring, Christine, Behre, Gerhard, Ziemer, Mirjana
Format: Article
Language:English
Subjects:
acute intestinal graft-versus-host disease
Apheresis
Bronchiolitis obliterans
bronchiolitis obliterans syndrome
Bronchopneumonia
Corticosteroids
Diarrhea
Endoscopy
extracorporeal photopheresis
Graft versus host disease
Graft versus host reaction
Intestine
Lung transplants
Medical research
Medicine, Experimental
Mortality
Patients
Respiratory function
Steroids
Transplantation
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Summary:Background: Patients with steroid-refractory intestinal acute graft-versus-host disease (aGvHD) and bronchiolitis obliterans syndrome (BOS) represent a population with a high need for alternative and effective treatment options. Methods: We report real-life data from 18 patients treated with extracorporeal photopheresis (ECP). This cohort consisted of nine patients with steroid-refractory intestinal aGvHD and nine patients with BOS. Results: We document partial or complete clinical response and reduction of symptoms in half of the patients with intestinal acute GvHD and patients with BOS treated ECP. Responding patients tended to stay on treatment longer. In patients with BOS, stabilization of lung function and forced expiratory volume was observed, whereas, less abdominal pain, less diarrhea, and a reduction of systemic corticosteroids were seen in patients with intestinal acute GvHD. Conclusions: ECP might not only abrogate symptoms but also reduce mortality caused by complications from high-dose steroid treatment. Taken together, ECP offers a serious treatment avenue for patients with steroid-refractory intestinal acute GvHD and BOS.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines10081887