Ocular manifestations of chronic graft-versus-host disease in patients treated with extracorporeal photochemotherapy.

Abstract

PURPOSE:

Eye involvement has long been appreciated in patients with chronic graft versus host disease (cGVHD). In particular, ocular complications are frequent and can be potentially severe in patients with steroid-refractory cGVHD, and therefore necessitate close monitoring. This prospective study was designed to describe eye manifestations of cGVHD in a large series of patients monitoring them before and after 1 year of extracorporeal photochemotherapy (ECP). ECP is a relatively new therapeutic approach based on the biological effects of psoralen 8-methoxypsoralen (8-MOP) and ultraviolet A light (UVA) on mononuclear cells collected by apheresis, and reinfused into the patient.

METHODS:

Only patients with steroid-refractory cGVHD under treatment with ECP, who developed cGVHD-related eye symptoms, were selected for the study. Ophthalmologic examination was repeated every 3 months. Only patients with complete recovery of the ocular manifestations and symptoms were considered responsive.

RESULTS:

In our study we observed eye alterations in 24 out of 140 patients (17%) with cGVHD. After 12 months of ECP, 10 out of 21 patients (48%) completely responded to the therapy. In all these cases the contribution of ECP was also essential in all the other organs subject to cGVHD.

CONCLUSIONS:

Further studies are necessary to clarify the role of ECP in patients with cGVHD, especially in associated eye manifestations. Although our experience is limited, it suggests that ECP could be a safe and effective therapy for steroid-refractory eye manifestations of cGVHD.

• Authors: E Motolese, P Rubegni, S Poggiali, P A Motolese, G Marotta, L Russo, G D'Ascenzo, M R Carcagni, M Fruschelli, I Motolese, M Fimiani
• Journal: European journal of ophthalmology (Eur J Ophthalmol) 2007 Nov-Dec Vol. 17 Issue 6 Pg. 961-9 ISSN: 1120-6721 [Print] United States
• PMID: 18050124 (Publication Type: Journal Article)

Chemical References

• Methoxsalen

Topics

• Adolescent
• Adult
• Chronic Disease
• Eye Diseases (etiology, therapy)
• Female
• Graft vs Host Disease (etiology, therapy)
• Hematologic Diseases (therapy)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Male
• Methoxsalen (therapeutic use)
• Middle Aged
• Photopheresis (methods)
• Prospective Studies
• Transplantation, Homologous
• Ultraviolet Rays