scholarly journals Role of Extracorporeal Photopheresis (ECP) in Treatment of Steroid-Refractory Acute Graft-versus-Host Disease

2010 ◽  
Vol 16 (12) ◽  
pp. 1747-1748 ◽  
Author(s):  
Hildegard T. Greinix ◽  
Nina Worel ◽  
Robert Knobler
Keyword(s):  
Graft Versus Host Disease ◽  
Extracorporeal Photopheresis ◽  
Host Disease ◽  
Graft Versus Host ◽  
Steroid Refractory ◽  
Acute Graft

scholarly journals Experience with the Use of Infliximab and/or Extracorporeal Photopheresis in Steroid-Refractory Acute Graft Versus Host Disease

2018 ◽  
Vol 24 (3) ◽  
pp. S194 ◽  
Author(s):  
Marietta Nygaard ◽  
Tonny Karlsmark ◽  
Niels Smedegaard ◽  
Ida Schjødt ◽  
Lone S. Friis ◽  
...  
Keyword(s):  
Graft Versus Host Disease ◽  
Extracorporeal Photopheresis ◽  
Host Disease ◽  
Graft Versus Host ◽  
Steroid Refractory ◽  
Acute Graft

Rituximab Reduces the Incidence of Acute Graft Versus Host Disease in an Unselected Series of Twenty-One Patients Undergoing Allogeneic Stem Cell Transplantation at a Single Center.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2875-2875
Author(s):  
M. Christopeit ◽  
L. Mueller ◽  
W. Grothe ◽  
T. Weber ◽  
A. Muetherig ◽  
...  
Keyword(s):  
B Lymphocytes ◽  
Graft Versus Host Disease ◽  
Donor Lymphocyte Infusion ◽  
Host Disease ◽  
Graft Versus Host ◽  
Non Hodgkin Lymphoma ◽  
Anti Cd20 ◽  
Steroid Refractory ◽  
Acute Graft

Abstract Recent evidence highlights an implication of B lymphocytes in the development and sustainment of chronic graft versus host disease (cGvH). The monoclonal anti-CD20-antibody rituximab has proven effective against steroid refractory cGvH. Data on the role of B lymphocytes in acute GvH (aGvH) is sparse. We report on a reduction of the incidence of aGvH in patients receiving rituximab as an element of conditioning as compared to patients conditioned without rituximab. All 6 patients receiving rituximab suffered from CD20 positive Non-Hodgkin-Lymphoma (NHL) and received cyclosporine and mycophenolate immunosuppression. Immunosuppression in the other 15 patients was achieved either with cyclosporine and mycophenolate (N=11) or cyclosporine and methotrexate (N=4). All patients except for one received dose reduced conditioning. Only patients beyond day 25 are included in the analysis; as of july 20th, 2006 median follow up is 151 days (range 27 to 322 days). Out of six patients receiving rituximab as an element of conditioning, one (16.7 %) developed moderate aGvH. Out of 15 patients who did not receive rituximab during conditioning, 10 (66.7 %) developed moderate to severe aGvH. Two patients developed severe acute GvH after early cessation of immunosuppression and/or donor lymphocyte infusion for progressive disease. If removed from this analysis, 8 out of 13 patients (61.5 %) developed aGvH after conditioning without rituximab. Taken together, these data present a trend that in patients conditioned with rituximab acute GvH occurs less frequently. These are amongst the first data indicating that rituximab might suppress the development of acute GvH. They are in accordance with work published before yet this is the first study systematically comparing two groups of patients. At present, no data exploring the influence of CD20 positive B lymphocytes or the effect of rituximab on graft-versus-tumor effects exist. It therefore remains to be investigated whether the suggested suppression of GvH by rituximab benefits overall survival by reducing transplantation related mortality or whether it is associated with a higher relapse rate due to an abrogated graft versus tumor effect. Furthermore, it remains to be elucidated whether the administration of rituximab before transplantation or during the restoration of the allogeneic immune system exerts prophylactic effects against cGvH and whether this influences both graft versus tumor effects and survival. Finally, we conclude that the addition of rituximab to the treatment of severe steroid refractory acute graft versus host reactions has to be tested in randomized trials.

Extracorporeal photopheresis and anticytokine therapy in the treatment of steroid-refractory acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation in children

2016 ◽  
Vol 7 (1) ◽  
pp. 58-64
Author(s):  
Andrey V Kozlov ◽  
Julia G Fedukova ◽  
Tatzana A Bykova ◽  
Ivan S Moiseev ◽  
Marya A Estrina ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Graft Versus Host Disease ◽  
Extracorporeal Photopheresis ◽  
Hematopoietic Stem ◽  
Host Disease ◽  
Graft Versus Host ◽  
Anticytokine Therapy ◽  
Steroid Refractory ◽  
Acute Graft

Allogeneic hematopoietic stem cell transplantation (allo-SCT) is used widely in the management of children with hematological, oncological and inherited diseases. Study to compare efficiency of steroid-refractory acute graft versus host disease treatment (extracorporeal photopheresis (ECP) vs anticytokine therapy) was conducted in Raisa Gorbacheva Memorial Institute of Children Oncology, Hematology and Transplantation, First Pavlov State Medical University of Saint Petersburg. Sixty four children were included in the analysis. Patients were divided into two groups: first “group with ECP” (n = 31; 50,5 %) ("ECP group") and second - "group without ECP" (n = 33; 49,5 %). Treatment in the second group consisted of anticytokine therapy (etanercept (n = 12), infliximab (n = 9), daclizumab (n = 8)) and alemtuzumab (n = 4). Ten-year overall survival (OS) of children with steroid-refractory acute graft versus host disease was 39 % without difference in OS between ECP and anticytokine therapy (5-year OS 40 % vs 35 %, p = 0,34). Response rate to the therapy was also the same in both groups (68 % after ECP and 70 % after anticytokine therapy, p = 0,77). Difference in cumulative incidence of relapse in "ECP group" and "group without ECP" was not statistically significant (18 % and 7 %, respectively, p = 0,2). In conclusion, ECP and anticytokine therapy are equally effective in the treatment of children with steroid-refractory acute graft versus host disease and are associated with the same cumulative incidence of relapse.

scholarly journals Outcomes of Extracorporeal Photopheresis (ECP) in Treatment of Severe Acute Graft-Versus-Host Disease (aGvHD)

2021 ◽  
Vol 27 (3) ◽  
pp. S297-S298
Author(s):  
Zachary J Sebghati ◽  
Haitham Abdelhakim ◽  
Anurag K Singh ◽  
Leyla Shune ◽  
Siddhartha Ganguly ◽  
...  
Keyword(s):  
Graft Versus Host Disease ◽  
Extracorporeal Photopheresis ◽  
Host Disease ◽  
Graft Versus Host ◽  
Acute Graft
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