Extracorporeal photopheresis in the treatment of chronic graft-versus-host disease. The Hellenic experience: A study by the Hellenic association of hematology

Tsirigotis, Panagiotis; Kaloyannidis, Panayotis; Papalexandri, Apostolia; Baltadakis, Ioannis; Karakasis, Dimitrios; Batsis, Ioannis; Sakellari, Ioanna; Kitra, Vasiliki; Goussetis, Evgenios; Papageorgiou, Sotirios G.; Spyridonidis, Alexandros; Graphakos, Stelios; Harhalakis, Nikolaos; Dervenoulas, Ioannis; Anagnostopoulos, Achilles

doi:10.1016/j.transci.2011.09.001

Cited by 15 publications

(9 citation statements)

References 34 publications

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“…The study showed that ECP combined with standard therapy produced a greater improvement in the skin score compared with standard therapy alone, even though a statistically significant difference was not achieved and suggested that ECP could have a steroid-sparing effect in the treatment of cGVHD [97]. The same effect was shown in other studies [98,99] and, moreover, ECP should minimize the rate of relapse of malignant disease [100]. In a recent study, Tsirigotis et al [101] evaluated the influence of ECP on the numbers of CD4 + , CD8 + , CD20 + , CD56 + cells and on T-regulatory (Tregs), as well as on the numbers of naïve, central memory (CM), and effector memory (EM) T cells in patients treated for refractory cGVHD.…”

Section: Cgvhd Therapymentioning

confidence: 68%

“…Tsirigotis et al [100] Retrospective 58 57 NA The cumulative incidence of relapse in responders to ECP was 6%, in non-responders was 25% cGVHD: Chronic graft-versus-host disease; CR: Complete remission; ECP: Extracorporeal photopheresis; NA: Not applicable for criteria not well-defined; NRM: Nonrelapse mortality; PR: Partial remission.…”

Section: Authors Study No %Cr %Pr Commentmentioning

confidence: 99%

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Extracorporeal photopheresis, a therapeutic option for cutaneous T-cell lymphoma and immunological diseases: state of the art

Martino

Fedele

Cornelio

et al. 2012

Expert Opinion on Biological Therapy

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ECP is efficacious in a high percentage of those cutaneous T-cell lymphoma patients who have circulating malignant T cells in the context of a still-near-normal immune competence. From the side of graft-versus-host disease (GVHD), the use of ECP showed a clinical benefit in patients with steroid-refractory acute GVHD (aGVHD) and it is believed that ECP deserves to be evaluated as part of a combination strategy in first-line therapy of aGVHD. In chronic GHVD, the published data show that ECP can be effective in extensive and long-standing disease even when treatment is initiated at an advanced stage after conventional immunosuppressive and corticosteroid therapy has failed. ECP should be considered most beneficial for patients with predominantly mucocutaneous chronic GVHD. The fields of application of the procedure could be vast, and could also include autoimmune and metabolic diseases. The most important methodological issues which affect ECP evaluation is that the large majority of data about ECP result from single-arm observational series and the significant efficacy is mainly based on small and retrospective studies. ECP has never been proved to offer any survival advantage in a context of a randomized trial and the above-mentioned limitation also affects the accuracy of many biological modifications observed during ECP. Starting from these considerations, the need of a prospective randomized study becomes increasingly urgent.

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Section: Cgvhd Therapymentioning

confidence: 68%

Section: Authors Study No %Cr %Pr Commentmentioning

confidence: 99%

Extracorporeal photopheresis, a therapeutic option for cutaneous T-cell lymphoma and immunological diseases: state of the art

Martino

Fedele

Cornelio

et al. 2012

Expert Opinion on Biological Therapy

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“…Dasselbe gilt für das primär kutane großzellige anaplastische T-Zell-Lymphom und die lymphomatoide Papulose [20]. [25,29].…”

Section: Kutanes T-zell-lymphom (Ctlc)unclassified

Extrakorporale Photopherese in der Dermatologie: ein Update

Knobler

Just

2018

Akt Dermatol

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ZusammenfassungDas Grundprinzip der extrakorporalen Photopherese (ECP) besteht in der Isolierung von kernhaltigen Blutzellen durch Zentrifugalkraft (Leukapherese), Behandlung des Apheresates mit 8-Methoxypsoralen, Bestrahlung mit ultraviolettem Licht und Reinfusion. Diese Behandlung wurde vor 30 Jahren zunächst für die Therapie des kutanen T-Zell-Lymphoms entwickelt. Da die ECP eine Modulation der durch T-Zellen vermittelten Immunität bewirkt, wurde sie später auch in Indikationen, die auf einer Fehlregulation der zellulären Abwehr beruhen, etabliert. In der Dermatologie zählen hierzu v. a. die akute und chronische Graft-versus-Host-Krankheit, die systemische Sklerose, die therapierefraktäre atopische Dermatitis und bestimmte blasenbildende Autoimmundermatosen. Die ECP kann als wirksame und sichere Therapieoption für diese teils lebensbedrohenden, schmerzhaften und psychisch belastenden Hautkrankheiten angesehen werden. In den meisten Fällen erlaubt die ECP eine Dosisreduktion von Kortikosteroiden. In manchen Indikationen fehlen jedoch noch die für eine wissenschaftlich fundierte Bewertung notwendigen randomisierten Vergleichsstudien.

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“…A selection of the larger studies is listed in Table 2 [61,[66][67][68][69]. Retrospective studies provide the bulk of the evidence for ECP in cGVHD [53,68,[70][71][72][73], most as a second-line therapy. There is 1 published phase II randomized trial [69], and a clinical trial evaluating its role as an initial therapy is underway (ClinicalTrials.gov Identifier: NCT01380535).…”

Section: Chronic Gvhdmentioning

confidence: 99%

National Institutes of Health State of the Science Symposium in Therapeutic Apheresis: Scientific Opportunities in Extracorporeal Photopheresis

Ratcliffe

Dunbar

Adamski

et al. 2015

Transfusion Medicine Reviews

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Extracorporeal photopheresis in the treatment of chronic graft-versus-host disease. The Hellenic experience: A study by the Hellenic association of hematology

Cited by 15 publications

References 34 publications

Extracorporeal photopheresis, a therapeutic option for cutaneous T-cell lymphoma and immunological diseases: state of the art

Extracorporeal photopheresis, a therapeutic option for cutaneous T-cell lymphoma and immunological diseases: state of the art

Extrakorporale Photopherese in der Dermatologie: ein Update

National Institutes of Health State of the Science Symposium in Therapeutic Apheresis: Scientific Opportunities in Extracorporeal Photopheresis

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