Role of extracorporeal photopheresis (ECP) in treatment of steroid-refractory acute graft-versus-host disease.

摘要

Recently, Pidala and Anasetti [1] presented a review on glucocorticoid-refractory acute graft-versus-host disease (aGVHD), which included options for salvage therapies and future directions in this distinguished scientific journal. Whereas salvage strategies with antilymphocyte antibodies, immunotoxins, antitumor necrosis factor alpha therapy, and immunomodulatory agents were described in detail citing numerous studies with sometimes small patient numbers both in the text as well as in Tables 1 to 3, in the section on extracor-poreal photopheresis (ECP) important studies are missing [2-5]. Considering their results, complete resolution (CR) rates would be as high as 73% [4] and organ-specific CR rates would also increase in skin manifestations up to 92% [4], in liver involvement up to 100% [4], and in gastrointestinal (GI) manifestations up to 83% [3], respectively. The authors specifically mentioned conflicting data on CR rates in GI manifestations of steroid-refractory aGVHD, citing our pilot study with 21 patients [6].