PHOTOCHEMOTHERAPIE (PUVA) FOR ACUTE GRAFT -VERSUS-HOST DISEASE

For several years, psoralen and UV-A light (PUVA) therapy has been use d in the treatment of chronic graft-versus-host disease (GvHD) followi ng allogeneic bone marrow transplantation (BMT). There is little exper ience with PUVA treatment of acute GvHD. Allogeneic BMT was performed in 25 patients, 10 of whom developed acute GvHD despite immunosuppress ive therapy. Six patients with acute cutaneous GvHD grade II III (n=2 grade 11, n=4 grade III) were treated with PUVA. We present the result s. All the PUVA-treated patients improved markedly after 5-12 sessions of irradiation. In 5 patients the skin cleared completely with 8-18 t reatments. In 4 patients chronic GvHD was prevented by maintenance tre atment for up to 10 months. Following clearing of acute cutaneous GvHD , 2 patients developed chronic GvHD after therapy-free intervals of 3 and 12 months, respectively. These results indicate a beneficial effec t of PUVA in acute cutaneous GvHD and suggest a protective effect agai nst chronic GvHD.