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Longitudinal follow-up of response status and concomitant immunosuppression in patients treated with extracorporeal photopheresis for chronic graft versus host disease

Bone Marrow Transplantation volume 54, pages 35–43 (2019)Cite this article

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Abstract

Improvement in chronic graft vs. host disease (cGvHD) following treatment with extracorporeal photopheresis (ECP) has been shown previously. However, the effect is often measured at only one point in time or as best response. Chronic GvHD activity fluctuates over time, so we retrospectively evaluated cGvHD responses in 54 patients with primarily moderate or severe cGvHD throughout the ECP treatment course and after stopping ECP. The dominant response was partial remission (PR) in 33 patients, no change (NC) in 10 patients, progressive disease (PD) in 10 patients and complete remission (CR) in one patient. Response rates and reduction in glucocorticoid dose reached a plateau after nine months. The main reason for stopping ECP was the absence of further improvement. Flares in cGvHD activity were seen in 36 patients. Additional treatment during ECP was administered to 29 patients. Failure free survival with response was achieved for 52% of patients at 6 months and 43% at 1 year. Our study confirms that ECP is a safe option for cGvHD therapy. The majority of the patients experience improvement and reduction in glucocorticoid dose but flares in cGvHD activity and the need for additional immunosuppression are seen frequently.

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Acknowledgements

Supported by unrestricted grants from the Novo Nordisk Foundation (NNF15OC0014158) and the Danish Cancer Society.

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Authors and Affiliations

  1. Department of Hematology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, CopenhagenØ, 2100, Denmark

    Marietta Nygaard, Niels Smedegaard Andersen, Ida Marie Schjødt, Søren Lykke Petersen, Lone Smidstrup Friis, Brian Thomas Kornblit & Henrik Sengeløv

  2. Department of Dermatology, Bispebjerg hospital, University of Copenhagen, København, Denmark

    Tonny Karlsmark

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  1. Marietta Nygaard
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Correspondence to Marietta Nygaard.

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MN has received travel grant for conference participation and speakers fee from Therakos (Mallinckrodt). The remaining authors declare that they have no conflict of interest.

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Nygaard, M., Karlsmark, T., Andersen, N.S. et al. Longitudinal follow-up of response status and concomitant immunosuppression in patients treated with extracorporeal photopheresis for chronic graft versus host disease. Bone Marrow Transplant 54, 35–43 (2019). https://doi.org/10.1038/s41409-018-0206-5

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