Extrakorporale Photopherese mit permanentimplantierten subkutanen Vorhofkathetern

Background: Extracorporeal photopheresis (ECP) is a second-line therapy for steroid-refractory chronic graft-versus-host disease (cGVHD). Objective: We describe the long-term efficacy and tolerability of ECP according to the cutaneous phenotype of cGVHD and report on the reduced need for immunosuppressant drugs in this setting. Patients and Methods: Fourteen patients (8 females) with cutaneous and/or mucosal cGVHD, treated with ECP between October 2010 and May 2016 within a single center, were included. Final analyses included patients who had received ECP for at least 12 months. We prospectively evaluated the efficacy of ECP using lesion-specific clinical scores and by recording changed doses of systemic immunosuppressants. Results: Of the 14 patients, sclerotic skin lesions were present in 10 (71%). The mRODNAN score decreased in all patients from month 9 onwards, with 40 and 77% reductions at 12 and 36 months, respectively. Six patients (43%) presented with cutaneous lichenoid lesions: this score was reduced in all patients by month 3, reaching a 93% reduction by month 12. Five patients (36%) experienced oral mucosal lichenoid lesions: these scores were decreased by 55% at month 12 and by 100% by month 33. The use of systemic immunosuppressants was reduced in all patients; 4 patients could stop all immunosuppressant drugs after 2 years. ECP was stopped in 3 patients after a complete response. No major ECP-associated adverse effects were observed. Discussion and Conclusion: ECP was an effective long-term therapy for oral and cutaneous cGVHD: consequently, dose levels of therapeutic immunosuppression could be reduced.

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Extrakorporale Photopherese ? Therapieoption beim Skleromyx�dem?

Der Hautarzt ◽

10.1007/s001050170002 ◽

2001 ◽

Vol 52 (0) ◽

pp. 938-941 ◽

Cited By ~ 4

Author(s):

B. Khan Durani ◽

H. N�her ◽

M. Bock

Keyword(s):

Extrakorporale Photopherese

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Extrakorporale Photopherese

Physikalische Therapiemaßnahmen in der Dermatologie ◽

10.1007/978-3-7985-1626-7_5 ◽

2006 ◽

pp. 32-36

Author(s):

J. A. Kamarachev

Keyword(s):

Extrakorporale Photopherese

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Extrakorporale Photopherese

Der Hautarzt ◽

10.1007/s00105-008-1500-8 ◽

2009 ◽

Vol 60 (4) ◽

pp. 337-344 ◽

Cited By ~ 1

Author(s):

U. Just ◽

R. Knobler

Keyword(s):

Extrakorporale Photopherese

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Extrakorporale Photopherese bei Graft-versus-Host-Disease

JDDG Journal der Deutschen Dermatologischen Gesellschaft ◽

10.1111/j.1610-0387.2008.06591_supp.x ◽

2008 ◽

Vol 6 (6) ◽

pp. ---

Author(s):

Maria Rosaria Carcagnì ◽

Giovambattista De Aloe ◽

Giuseppina D'Ascenzo ◽

Pietro Rubegni ◽

Michele Fimiani

Keyword(s):

Graft Versus Host Disease ◽

Extrakorporale Photopherese ◽

Host Disease ◽

Graft Versus Host

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Extrakorporale Photopherese zur Therapie der progressiven systemischen Sklerodermie: Ein neuer Therapieansatz

Aktuelle Rheumatologie ◽

10.1055/s-2008-1043540 ◽

1999 ◽

Vol 24 (01) ◽

pp. 7-17

Author(s):

Claudia Graefe ◽

C. Luderschmidt ◽

T. Arnim

Keyword(s):

Extrakorporale Photopherese

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Die Extrakorporale Photopherese bei Progressiver Systemischer Sklerodermie: Unterscheidung von Respondern und Non-Respondern. Extracorporeal photopheresis in progressive systemic sclerosis: discrimination of responders and non-responders

JDDG Journal der Deutschen Dermatologischen Gesellschaft ◽

10.1046/j.1439-0353.2003.03747.x ◽

2003 ◽

Vol 1 (12) ◽

pp. 945-951 ◽

Cited By ~ 3

Author(s):

Stefanie Reich ◽

Michael Radenhausen ◽

Peter Altmeyer ◽

Klaus Hoffmann

Keyword(s):

Systemic Sclerosis ◽

Progressive Systemic Sclerosis ◽

Extracorporeal Photopheresis ◽

Extrakorporale Photopherese

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Update zur Extrakorporalen Photopherese

hautnah ◽

10.1007/s12326-021-00467-1 ◽

2021 ◽

Author(s):

R. Knobler ◽

T. Valero ◽

U. Just

Keyword(s):

Atopische Dermatitis ◽

Extrakorporale Photopherese ◽

Graft Versus Host

ZusammenfassungVor über 30 Jahren wurde ein von der PUVA abgeleitetes Therapiekonzept zur Behandlung von therapierefraktären kutanen T‑Zell-Lymphomen (CTCL), insbesondere dem Sézary-Syndrom, entwickelt. R. Edelson hat Leukapherese mit Photochemotherapie verbunden, wodurch Zellen des peripheren Blutes extrakorporal nach Photosensibilisierung mittels Psoralen mit UVA-Licht bestrahlt und anschließend rückinfundiert werden. Im Jahr 1987 wurde dieses neue Behandlungskonzept mit dem Namen extrakorporale Photopherese (ECP) erstmals publiziert. Nach den ersten positiven Erfahrungen mit CTCL wurde diese Behandlung bei weiteren Indikationen erfolgreich angewendet, darunter Erkrankungen wie akute und chronische Graft-versus-Host-Reaktion (GvHD), Sklerodermie sowie atopische Dermatitis (AD). Eine zunehmende Anwendung hat die ECP in den letzten Jahren in der Behandlung von akuten und chronischen Abstoßungsreaktionen nach Organtransplantation, insbesondere Herz- und Lungentransplantation, erhalten. Im Jahr 2021 gibt es über 200 Zentren weltweit, welche die ECP erfolgreich einsetzen.

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