Extracorporeal photopheresis for graft-vs-host disease : A literature review and treatment guidelines proposed by the Nordic ECP Quality Group
Nygaard, Marietta ; Wichert, Stina LU
; Berlin, Gösta
and Toss, Fredrik
(2020)
In European Journal of Haematology
104(5).
p.361-375
- Abstract
Extracorporeal photopheresis (ECP) is one of the most used and established therapies for steroid-refractory graft-vs-host disease (GvHD), with a good effect to side effect profile. In this review, we present a summary of present literature and provide evidence-based treatment guidelines for ECP in GvHD. The guidelines constitute a consensus statement formed by the Nordic ECP Quality Group representing all ECP centres in the Nordic countries, and aims to facilitate harmonisation and evidence-based practice. In developing the guidelines, we firstly conducted a thorough literature search of original articles and existing guidelines. In total, we identified 26 studies for ECP use in acute GvHD and 36 in chronic GvHD. The studies were... (More)
Extracorporeal photopheresis (ECP) is one of the most used and established therapies for steroid-refractory graft-vs-host disease (GvHD), with a good effect to side effect profile. In this review, we present a summary of present literature and provide evidence-based treatment guidelines for ECP in GvHD. The guidelines constitute a consensus statement formed by the Nordic ECP Quality Group representing all ECP centres in the Nordic countries, and aims to facilitate harmonisation and evidence-based practice. In developing the guidelines, we firstly conducted a thorough literature search of original articles and existing guidelines. In total, we identified 26 studies for ECP use in acute GvHD and 36 in chronic GvHD. The studies were generally small, retrospective and heterogeneous regarding patient characteristics, treatment schedule and outcome assessment. In general, a majority of patients achieved partial response or better, but response rates varied by the organs affected. Head-to-head comparisons to other treatment modalities were lacking. Overall, we consider the quality of evidence to be low–moderate (GRADE) and encourage future prospective multi-armed trials to strengthen the present recommendations. However, despite limitations in evidence strength, standardised treatment schedules and regular follow-up are imperative to ensure the best possible patient outcome.
(Less)
- author
- Nygaard, Marietta
; Wichert, Stina
LU
; Berlin, Gösta
and Toss, Fredrik
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- graft-vs-host disease, hematologic neoplasms, hematopoietic stem cell transplantation, immune tolerance, immunomodulation, photopheresis
- in
- European Journal of Haematology
- volume
- 104
- issue
- 5
- pages
- 15 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:31908057
- scopus:85083907852
- ISSN
- 0902-4441
- DOI
- 10.1111/ejh.13381
- language
- English
- LU publication?
- no
- id
- 585c5ac2-ccd3-4e0e-9d1a-d5e27c5d6e58
- date added to LUP
- 2020-05-19 07:50:58
- date last changed
- 2024-04-03 06:34:49
@article{585c5ac2-ccd3-4e0e-9d1a-d5e27c5d6e58,
abstract = {{<p>Extracorporeal photopheresis (ECP) is one of the most used and established therapies for steroid-refractory graft-vs-host disease (GvHD), with a good effect to side effect profile. In this review, we present a summary of present literature and provide evidence-based treatment guidelines for ECP in GvHD. The guidelines constitute a consensus statement formed by the Nordic ECP Quality Group representing all ECP centres in the Nordic countries, and aims to facilitate harmonisation and evidence-based practice. In developing the guidelines, we firstly conducted a thorough literature search of original articles and existing guidelines. In total, we identified 26 studies for ECP use in acute GvHD and 36 in chronic GvHD. The studies were generally small, retrospective and heterogeneous regarding patient characteristics, treatment schedule and outcome assessment. In general, a majority of patients achieved partial response or better, but response rates varied by the organs affected. Head-to-head comparisons to other treatment modalities were lacking. Overall, we consider the quality of evidence to be low–moderate (GRADE) and encourage future prospective multi-armed trials to strengthen the present recommendations. However, despite limitations in evidence strength, standardised treatment schedules and regular follow-up are imperative to ensure the best possible patient outcome.</p>}},
author = {{Nygaard, Marietta and Wichert, Stina and Berlin, Gösta and Toss, Fredrik}},
issn = {{0902-4441}},
keywords = {{graft-vs-host disease; hematologic neoplasms; hematopoietic stem cell transplantation; immune tolerance; immunomodulation; photopheresis}},
language = {{eng}},
number = {{5}},
pages = {{361--375}},
publisher = {{Wiley-Blackwell}},
series = {{European Journal of Haematology}},
title = {{Extracorporeal photopheresis for graft-vs-host disease : A literature review and treatment guidelines proposed by the Nordic ECP Quality Group}},
url = {{http://dx.doi.org/10.1111/ejh.13381}},
doi = {{10.1111/ejh.13381}},
volume = {{104}},
year = {{2020}},
}