The role of phototherapy in cutaneous chronic graft-vs-host disease: a retrospective study and review of the literature.

Autores de IIS La Fe

• Rosa Ballester Sanchez

  Autor

• Miguel Ángel Navarro Mira

  Autor

• Blanca De Unamuno Bustos

  Autor

• Conrad Pujol Marco

  Autor

• Jaime Sanz Caballer

  Autor

• 

  Rafael Botella Estrada

  Autor

Grupos

• Dermatología y Regeneración Tisular

• Hematología y Hemoterapia

• Investigación Clínica y Traslacional en Cáncer

Abstract

INTRODUCTION AND OBJECTIVES: Cutaneous chronic graft-vs-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation. Phototherapy is a therapeutic option for patients with skin involvement and for those who require high doses of corticosteroids. We analyze the cases treated in our department and review the literature. MATERIAL AND METHODS: All patients with GVHD treated with phototherapy in the dermatology department of Hospital Universitario y Politecnico la Fe in Valencia, Spain between March 2011 and October 2014 were identified. Data were gathered retrospectively. RESULTS: There were 16 patients: 10 treated with psoralen-UV-A and 6 with narrowband-UV-B. Complete response was achieved in 9 patients and partial response in 7; 2 patients with partial responses relapsed after treatment. Ten patients were able to decrease their dose of corticosteroids during treatment, and a further 3 decreased the number of other immunosuppressant drugs. No serious adverse effects occurred. CONCLUSIONS: Phototherapy is a good therapeutic option for patients with chronic GVHD with extensive cutaneous involvement, as well as for those who fail to respond to topical treatment or who have become steroid-dependent. The main benefits are that, as the treatment targets the skin, it reduces corticosteroid requirements and has a good safety profile. Treatment must be individualized and, in our experience, both the initial dose and the maximum dose per session can be lower than for other diseases.

Keywords

• *Cutaneous chronic graft-vs-host disease; *Enfermedad injerto contra huesped cronica cutanea; *Fototerapia; *Narrowband-UV-B; *PUVA; *Phototherapy; *Psoralen-UV-A; *UVB-BE