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Peri-transplant extracorporeal photopheresis to mitigate GVHD- a pilot clinical trial

Bone Marrow Transplantation volume 56, pages 980–982 (2021)Cite this article

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Graft-versus-host disease (GVHD) is a significant cause of morbidity and mortality among patients undergoing hematopoietic stem cell transplantation (HSCT) [1, 2]. Patients with steroid-refractory acute GVHD (aGVHD) have a high incidence of nonrelapse mortality (60–65%) with 2-year overall survival of only 18–25% [3]. Extracorporeal Photopheresis (ECP) has shown activity in the treatment of GVHD in multiple studies [4, 5]. The proven efficacy and relatively few side effects make ECP use to prevent acute and chronic GVHD a desirable strategy.

Few clinical trials have sought to investigate the role of ECP in preventing GVHD [6,7,8,9]. One study demonstrated improved survival and delayed onset of aGVHD in a study where patients received 2 ECP treatments pre-myeloablative conditioning for the transplant [7]. Kitko et al. utilized prophylactic ECP post-transplant combined with TNF alpha inhibition and showed improved response to GVHD therapy [6]. In the present study, we investigated the role of peri-transplant ECP (pre-conditioning and post-engraftment) to prevent GVHD when added to standard GVHD prophylaxis in myeloablative conditioning HSCT.

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Fig. 1: Trial design and outcomes.

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Authors and Affiliations

  1. Division of Hematological Malignancies and Cellular Therapy, University of Kansas Medical Center, Kansas City, KS, USA

    Haitham Abdelhakim, Dean Merkel, Shaun Dejarnette, Siddhartha Ganguly, Joseph McGuirk & Sunil Abhyankar

  2. University of Kansas Cancer Center, Kansas City, KS, USA

    Haitham Abdelhakim, Siddhartha Ganguly, Joseph McGuirk & Sunil Abhyankar

  3. Dreiling/Schmidt Cancer Institute, University of Kansas Health System, Hays, KS, USA

    Anthony Accurso

  4. Division of Hematology and Bone Marrow Transplantation, University of Rochester Medical Center, Rochester, NY, USA

    Omar Aljitawi

  5. Department of Microbiology, Molecular Genetics & Immunology, University of Kansas School of Medicine, Kansas City, KS, USA

    Thomas Yankee

  6. Department of Biostatistics & Data Science, University of Kansas School of Medicine, Kansas City, KS, USA

    Jianghua He

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  1. Haitham Abdelhakim
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Correspondence to Sunil Abhyankar.

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Conflict of interest

A grant from Mallinckrodt Pharmaceuticals funded this research. However, Mallinckrodt Pharmaceuticals had no role in clinical trial design, data collection, analysis, or decision to publish.

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Abdelhakim, H., Accurso, A., Merkel, D. et al. Peri-transplant extracorporeal photopheresis to mitigate GVHD- a pilot clinical trial. Bone Marrow Transplant 56, 980–982 (2021). https://doi.org/10.1038/s41409-020-01142-4

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