Abstract:
Acute and chronic graft-versus-host-disease (GvHD) of the skin is a severe complication after stem cell transplantation. Until now, both types of GvHD can only be treated symptomatically.
The present retrospective, non-randomised study included 27 patients suffering from acute or chronic GvHD after allogeneic stem cell transplantation. We investigated the effect of photo(chemo)therapy with different wave lengths. On the clinical course of these patients systemic immunosuppression could be reduced.
The clinical effectiveness of PUVA-phototherapy has already been demonstrated in many studies and this was observed in our study as well.
In detail, acute GvHD responded better to all therapy options (systemic PUVA-phototherapy, topical PUVA-phototherapy, UVA-1 phototherapy and UVB-311 phototherapy) than chronic GvHD. The study shows that particularly systemic PUVA-phototherapy reduces GvHD which is reflected in a reduction of the systemic immunosuppressive therapy and improved clinical state of the skin.
Although these therapy options exist, acute and chronic GvHD constitute a severe complication after allogeneic stem cell transplant with a high morbidity and mortality rate. Therefore, further studies examining the pathogenesis and possible therapy options of graft-versus-host-disease have to be conducted.