Improvement of chronic pulmonary graft-vs-host disease manifesting as bronchiolitis obliterans organizing pneumonia following extracorporeal photopheresis.

Medical Oncology
Basak OyanEmin Kansu

Abstract

Despite use of combined immunosuppressive agents, prognosis of patients developing pulmonary manifestations of chronic graft-vs-host disease (cGVHD) following allogeneic stem cell transplantation (SCT) still remains poor. We present a male patient who developed pulmonary cGVHD in the form of bronchiolitis obliterans organizing pneumonia (BOOP) following allogeneic SCT for acute myelogenous leukemia. The patient developed progressive course despite use of a combination of immunosuppressive agents including high-dose prednisone, cyclosporin-A, and mycophenolate mofetil in addition to steroid-related complications. A remarkable clinical response to extracorporeal photopheresis (ECP) was observed, allowing minimization of immunosuppressive therapy and discontinuation of cyclosporin-A. Pulmonary functions and carbon monoxide diffusion capacity (DLCO) gradually improved and stabilized, but did not return to pretransplant baseline levels.

Citations

Oct 24, 2009·Clinical Transplantation·Chirag M Pandya, Ayman O Soubani
Jun 21, 2007·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Satoshi YoshiharaShin Mineishi
May 31, 2011·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Hildegard T GreinixUNKNOWN UVADEX Chronic GVHD Study Group
Oct 5, 2010·Hematology/oncology and Stem Cell Therapy·Ayman O Soubani, Chirag M Pandya

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