Chronic sclerodermic graft-versus-host disease refractory to immunosuppressive treatment responds to UVA(1) phototherapy

Graft-versus-host disease is a frequent complication of allogenic bone marr ow transplantation. Approximately 10% of patients suffering from chronic gr aft-versus-host disease develop sclerodermic graft-versus-host disease of t he skin, which often does not respond to conventional immunosuppressive the rapy. An alternative to immunosuppressive treatment is photochemotherapy. W e describe a patient with chronic sclerodermic graft-versus-host disease wh o did not respond to a combination therapy of cyclosporine and prednisone a nd later mycophenolate mofetil plus prednisone. A combination therapy of my cophenolate mofetil (2 g/day) and low-dose UVA(1) therapy (single dose, 20 J/cm(2), 4 times per week over 6 weeks) resulted in striking clinical impro vement of sclerodermic graft-versus-host disease.