Extracorporeal photopheresis with TC-V in Japanese patients with steroid-resistant chronic graft-versus-host disease

Springer Science and Business Media LLC - Tập 108 Số 3 - Trang 298-305 - 2018
Okamoto, Shinichiro1, Teshima, Takanori2, Kosugi-Kanaya, Mizuha2, Kahata, Kaoru3, Kawashima, Naomi4, Kato, Jun1, Mori, Takehiko1, Ozawa, Yukiyasu4, Miyamura, Koichi4
1Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
2Hematology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
3Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
4Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

Tóm tắt

There are few established therapies for chronic graft-versus-host disease (cGVHD) refractory to first-line treatment with steroids. We evaluated the efficacy and safety of extracorporeal photopheresis (ECP) with a third-generation TC-V device in Japanese patients with cGVHD. Fifteen patients with steroid-resistant or -intolerant cGVHD after allogeneic hematopoietic stem cell transplantation participated in this multicenter open-label study. Extracorporeal photopheresis was conducted on days 1–3, week 1; days 1–2, weeks 2–12; and days 1–2, weeks 16, 20, and 24. The composite primary endpoint consisted of evaluation of response and changes in steroid dose 24 weeks after ECP initiation. Secondary endpoints included response over time, concomitant drug dose, quality of life, and safety. Twelve patients completed scheduled ECP therapy; eight (66.7%) showed a response at week 24. In all 15 patients, the mean (± standard deviation) steroid dose decreased 0.115 ± 0.230 mg/kg/day from screening to week 24. Five serious, potentially treatment-related adverse events (heart failure, thrombosis in the device, pneumonia, edema, and wheezing) occurred; none were fatal. This study confirmed that ECP using the TC-V device was effective, with an acceptable toxicity profile. Further studies in larger cohorts are clearly warranted to determine its optimal use in Japanese patients with cGVHD.

Tài liệu tham khảo

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