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    Extracorporeal photopheresis in steroid-refractory chronic graft-versus-host disease: A retrospective multicenter study
    (Pergamon-Elsevier Science Ltd, 2021) Dal Sinan, Mehmet; Batgi, Hikmettullah; Erkurt, Mehmet Ali; Hindilerden, Ipek Yonal; Kuku, Irfan; Kurtoglu, Erdal; Kaya, Emin
    Background and objectives: Extracorporeal photopheresis (ECP) is a treatment strategy in steroid-refractory chronic graft-versus-host disease (cGvHD). In this study, we aimed to share our multicenter experience using ECP in our steroid-refractory cGvHD patients. Materials and methods: In this multicenter observational retrospective study with the participation of four Turkish transplant centers, 100 patients with the diagnosis of steroid-refractory cGvHD who underwent ECP were analyzed. All ECP procedures were performed with the off-line system. Results: Severe cGvHD was observed in 77 % of the patients. 50 % of the patients had more than 1 organ involvement. The overall response rate in cGvHD was 58 %, and the complete response (CR) rate was 35 %. The skin was the most involved organ, with a response rate of 61.2 % (CR rate 30.6 %) in cGvHD. At a median 13 months (1-261) follow-up, overall survival (OS) was 41 % (n = 41) and the mortality rate was 59 % (n = 59). Median overall survival (OS) was 2 months for non-responders and 91 months for responders (p < 0.001). Significant OS differences were observed for patients responding to ECP in cGvHD (HR = 4.1, p = 0.001) patients. Conclusions: ECP is a good therapeutic alternative and could be used earlier in patients with steroid-resistant cGvHD.
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    Extracorporeal photopheresis in the treatment of acute graft-versus-host disease: A multicenter experience
    (Pergamon-Elsevier Science Ltd, 2021) Batgi, Hikmettullah; Dal, Mehmet Sinan; Erkurt, Mehmet Ali; Kuku, Irfan; Kurtoglu, Erdal; Hindilerden, Ipek Yonal; Kaya, Emin
    Background and objectives: Extracorporeal photopheresis (ECP) is one of the second-line treatment strategies in steroid-refractory acute graft-versus-host disease (aGvHD). We aimed to share our multicenter experience using ECP in our steroid-refractory aGvHD patients. Materials and methods: A retrospective observational series of 75 aGvHD patients from 4 transplant centers were analyzed. All ECP procedures were performed with the off-line system. All patients received ECP as second-line therapy. Results: 74.7 % of aGvHD patients were grade 3 or 4. The overall response rate was 42.7 % (32/75) in aGvHD including 17 complete responses (22.7 %). Median follow-up was 6 months (range, 1-68). Median overall survival (OS) was 5 months for non-responders and 68 months for responders (p < 0.001). Twenty-seven (36 %) patients are alive, and 48 (64 %) patients have died. Conclusions: Early initiated ECP could be an effective treatment alternative in patients with steroid-refractory aGvHD.