In: NEOPLASMA, vol. 54, no. 5
P. Rzepecki - J. Barzal - T. Sarosiek - S. Oborska - C. Szczylik
Detaily:
Rok, strany: 2007, 431 - 436
O článku:
Chronic graft-versus-host disease (cGVHD) is a major cause of morbidity and mortality in long-term survivors of allogeneic
haematopoietic stem cell transplantation (alloHSCT). Ocular involvement as well as dermal sclerosis, joint contractures and
pathological changes in oral cavity are often refractory to treatment. This kind of patients require complex aggressive
immunosuppressive therapy. We are still waiting for drugs against cGVHD, characterized by decreased infectious
complications, encouraging efficacy and rare and reversible side effects. We describe eight patients who developed extensive
chronic graft versus host disease with eye involvement after alloHSCT. All had ocular manifestations, which were refractory
to the first and second line of systemic immunosuppressive therapy. All patients responded to the topical cyclosporine
therapy, but clinical improvement was seen only since the fifth month of starting treatment. Topical cyclosporine was well
tolerated. Other four patients with sclerodermoid type of skin changes, refractory to second line systemic immunosuppressive
therapy, were treated with clofazimine. Clofazimine is a drug used to treat leprosy. Because of its anti-inflammatory effects,
clofazimine is used also as a second or third line therapy for various skin disorders including: pyoderma gangrenosum, lupus
erythematosus, palmoplantar pustulosis and chronic graft versus host disease. All patients,who received clofazimine due to
dermal sclerosis, joint contractures and oral manifestations, achieved partial or complete responses and were able to reduce
other immunosuppressive drugs. Clofazimine was generally well tolerated.
Key words: Clofazimine- chronic graft-versus-host disease- dermal sclerosis- ocular involvement- topical cyclosporine
Ako citovať:
ISO 690:
Rzepecki, P., Barzal, J., Sarosiek, T., Oborska, S., Szczylik, C. 2007. How can we help patients with refractory chronic graft versus host
disease- single centre experience. In NEOPLASMA, vol. 54, no.5, pp. 431-436. 0028-2685.
APA:
Rzepecki, P., Barzal, J., Sarosiek, T., Oborska, S., Szczylik, C. (2007). How can we help patients with refractory chronic graft versus host
disease- single centre experience. NEOPLASMA, 54(5), 431-436. 0028-2685.