Steroid-Sparing Effect of Extracorporeal Photopheresis in the Treatment of Graft-vs-Host Disease

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Abstract
Chronic graft-vs-host disease (cGVHD) is a common and often devastating complication of hematopoietic cell transplantation. It occurs in 27% to 50% of sibling matched donor transplant cases and 42% to 72% of unrelated donor bone marrow or peripheral blood stem cell transplant cases.1 Although the cause is unclear, cGVHD–if it is an extension of acute GVHD–is believed to be related to activation of T cells of the donor against the recipient's major and minor histocompatibilty antigens.2 Some investigators believe that it is caused by the generation of autoantibodies and autoreactive T-cell clones.3 The primary targets are keratinocytes in the basal epidermis, bile canaliculi cells in the liver, and glandular cells in the intestinal tract.2