Narrowband ultraviolet B phototherapy for the treatment of steroid-refractory and steroid-dependent acute graft-versus-host disease of the skin - 14/09/11
Reprint requests: Rachel Abuav, MD, Cedars-Sinai Medical Group, 200 N Robertson Blvd, Suite 202, Beverly Hills, CA 90211.Abstract |
Background |
Acute graft-versus-host disease (aGvHD) is a common complication of allogeneic stem cell transplantation. It is usually treated with high doses of corticosteroids and other immunosuppressive agents. When cutaneous features are predominant, narrowband ultraviolet B (NB-UVB) phototherapy may be an attractive option for its steroid-sparing effect.
Objective |
We sought to examine the clinical efficacy of NB-UVB in the treatment of steroid-refractory and steroid-dependent cutaneous aGvHD.
Methods |
We conducted a retrospective chart review of patients with steroid-refractory and steroid-dependent aGvHD, who received NB-UVB between 2005 and 2009 at our institution.
Results |
We identified 14 patients with aGvHD treated with NB-UVB between 2005 and 2009. The median number of treatments was 15, administered over a median of 43 days. Eight of 14 patients (57%) achieved a complete response at the end of treatment; an additional 3 patients (21%) achieved a partial response; and 3 patients (21%) showed no improvement at the time when phototherapy was discontinued (nonresponders). Four patients developed chronic graft-versus-host disease (GvHD). Three of the 8 complete responders remained free of GvHD at 6 months’ follow-up.
Limitations |
The rarity of steroid-refractory aGvHD limited the study to a small number of participants. Because GvHD is variable in its presentation and course, and life-threatening in many cases, large controlled prospective trials for potential therapies are difficult.
Conclusions |
NB-UVB is a viable option for the treatment of steroid-refractory and steroid-dependent aGvHD of the skin.
Le texte complet de cet article est disponible en PDF.Key words : graft-versus-host disease, narrowband ultraviolet B, phototherapy, skin, steroid-refractory, ultraviolet light
Abbreviations used : aGvHD, GvHD, NB-UVB, PUVA, UV
Plan
| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 65 - N° 4
P. 733-738 - octobre 2011 Retour au numéro
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