Effects of extracorporeal photopheresis on survival in chronic graft versus host disease

Year 2024, Volume: 37 Issue: 3, 358 - 365, 30.10.2024

Ahmet Kaya , Mehmet Ali Erkurt , İrfan Kuku , Emin Kaya , İlhami Berber , Soykan Biçim , Süleyman Arslan , Ayse Uysal Fatma Hilal Yagın

https://doi.org/10.5472/marumj.1573775

Abstract

ABSTRACT
Objective: Chronic graft versus host disease (cGVHD) develops after allogeneic hematopoietic cell transplantation, when immune
cells from a non-identical donor initiate an immune reaction against the transplant recipient. Extracorporeal photopheresis (ECP) can
be used in combination with prednisone in steroid-resistant cGVHD. In this study, the effect of ECP use on survival in cGVHD was
examined.
Patients and Methods: Twenty-six patients who were followed up in the adult Hematology Clinic of Inonu University Turgut Ozal
Medical Center for cGVHD were included in the study. Stem cell transplantation and ECP application parameters that may affect the
survival of the patients were examined.
Results: The degree of involvement in cGVHD affects survival. Involvements with clinical and laboratory scores of 2 and above
according to the National Institutes of Health consensus criteria, significantly reduced survival. The development time of cGVHD
was found to be associated with survival, and that it had a positive impact on survival, especially when the disease developed after 220
days after the transplantation. It was observed that steroid dose taken during ECP, patient age and cGVHD prophylaxis used affected
survival.
Conclusion: The use of ECP may be effective in survival, especially, in patients who develop cGVHD, 220 days after allogeneic
transplantation. Concurrent use of steroids with ECP affects survival.

Keywords

Graft versus host disease, Allogeneic hematopoietic cell transplantation, Extracorporeal photopheresis, Survival

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