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Bath PUVA therapy in pediatric patients with drug-resistant cutaneous graft-versus-host disease

Bone Marrow Transplantation volume 28, pages 631–632 (2001)Cite this article

Chronic GVHD (cGVHD) occurs in about 25% of pediatric patients receiving allogeneic bone marrow transplantation.1 It may be limited or extensive with multiorgan involvement. Acute GVHD (aGVHD) develops in about 30–60% of HLA-identical transplants from siblings and mainly involves skin, liver and gut.2 Since 1991, published data report that drug-resistant cGVHD involving skin and oral mucosa can benefit from psoralen and ultraviolet A irradiation (PUVA therapy), which consists of exposure to UVA after photosensitization with orally administered 8-MOP.3,4,5,6 This approach has also recently been considered to be effective in a few cases of aGVHD.7

We describe four pediatric transplant patients successfully treated with PUVA therapy after failure of standard immunosuppressive therapies: we used an innovative procedure where 8-MOP is diluted in a bath and not administered orally. This kind of approach could reduce the possibility of systemic side-effects related to oral 8-MOP administration, and improves patient compliance. Furthermore, this procedure is currently adopted successfully for patients affected by dermatological diseases, such as psoriasis, where the autoimmune process could be involved as the major pathogenetic determinant.8

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Acknowledgements

The authors would like to thank Miss Joanna Upton for her language review and linguistic consultancy, Miss Sara Vaghi for secretarial support and the ‘Comitato Maria Letizia Verga per lo Studio e la Cura delle Leucemie dell'Infanzia’ for its continuous support of our research projects.

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Authors and Affiliations

  1. Pediatric Hematology Department, ‘Università di Milano-Biococca’, Monza, Italy

    S Bonanomi, A Balduzzi, A Tagliabue, E Biagi, A Rovelli, P Corti & C Uderzo

  2. Dermatology Department, S Gerardo Hospital, Via Donizetti 106, Monza, Italy

    D Crippa

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  1. S Bonanomi
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  2. A Balduzzi
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  8. C Uderzo
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Bonanomi, S., Balduzzi, A., Tagliabue, A. et al. Bath PUVA therapy in pediatric patients with drug-resistant cutaneous graft-versus-host disease. Bone Marrow Transplant 28, 631–632 (2001). https://doi.org/10.1038/sj.bmt.1703151

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