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Biol Blood Marrow Transplant. 2013 Jul;19(7):1129-33. doi: 10.1016/j.bbmt.2013.04.018. Epub 2013 Apr 25.

Extracorporeal photopheresis versus anticytokine therapy as a second-line treatment for steroid-refractory acute GVHD: a multicenter comparative analysis.

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1
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. madan.jagasia@vanderbilt.edu

Abstract

The optimal therapy for steroid-refractory (SR) acute graft-versus-host disease (aGVHD) is undefined. We studied patients with SR aGVHD, comparing extracorporeal photopheresis (ECP; n = 57) and anticytokine therapy (n = 41). In multivariate analyses, ECP, adjusted for steroid dose (odds ratio, 3.42; P = .007), and grade >II aGVHD (odds ratio, 68; P < .001) were independent predictors of response. ECP therapy, adjusted for conditioning regimen intensity and steroid dose, was associated with superior survival (hazard ratio [HR], 4.6; P = .016) in patients with SR grade II aGVHD. Grade >II aGVHD at onset of salvage therapy (HR, 9.4; P < .001) and lack of response to therapy (HR, 3.09; P = .011) were associated with inferior survival. These findings require validation in a prospective randomized study.

PMID:
23623892
DOI:
10.1016/j.bbmt.2013.04.018
[Indexed for MEDLINE]
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