Real-World Experience in Extracorporeal photopheresisfor adults with graft-versus-host disease.

Autores de IIS La Fe

• Pedro Asensi Cantó

  Autor

• Jaime Sanz Caballer

  Autor

• Pedro Miguel Aparicio Chorao

  Autor

• Manuel Nuno Direito De Morais Guerreiro

  Autor

• Juan Bautista Montoro Gómez

  Autor

• Miguel Ángel Sanz Alonso

  Autor

• 

  Javier De La Rubia Comos

  Autor

• Inés Gómez Seguí

  Autor

Participantes ajenos a IIS La Fe

• Sopeña Pell-Ilderton C
• Solís Ruiz J
• Lloret Madrid P
• Montaner Villalba M
• Facal Malvar A
• Balaguer Roselló A
• Santiago Balsera M
• Solves Alcaína P

Grupos

• Hematología y Hemoterapia

Abstract

INTRODUCTION: Extracorporeal photopheresis (ECP) has shown efficacy in graft-versus-host disease (GVHD). We aim to summarize eight years of real-world experience with off-line ECP in our institution, in order to validate this treatment schedule and analyze predictive factors. MATERIALS AND METHODS: All consecutive adult patients with steroid-dependent or steroidrefractory GVHD receiving off-line ECP were included in this single center, retrospective study. ECP was performed with Spectra Optia®, processing one total blood volume, with a frequency of twice a week for acute GVHD and once a week for chronic GVHD, and tapered individually according to clinical response. Cumulative incidence of response, including complete responses (CR) and partial responses (PR), were compared among patients grouped by different baseline, apheresis and disease characteristics. RESULTS: Between January 2015 and May 2022, 1382 ECP procedures were proposed for 82 patients. No incidents were reported in 97% of sessions. GVHD responded in 78% of patients (acute GVHD 57% CR and 4% PR, chronic GVHD 39% CR and 48% PR). Overall survival was statistically longer for acute GVHD patients responding to ECP than for those who did not (67.5% vs. 26% at one year, respectively; P?=?0.037). Severity was an independent predictor of response in acute GVHD whereas the absence of mouth involvement and lower lymphocyte counts in the apheresis product correlated with a higher response in chronic GVHD. DISCUSSION: This treatment schedule is effective for GVHD. Further investigation is required to identify ECP-specific predictive factors, as findings are not homogeneous among different studies.

Copyright © 2023. Published by Elsevier Inc.

Keywords

• Extracorporeal photopheresis; Graft-versus-host disease; Off-line ECP; Real-world experience