Abstract
Purpose
The aim of this systematic review was to evaluate the efficacy and safety of extracorporeal photopheresis (ECP) treatment in patients with steroid-refractory acute graft-versus-host disease (SR-aGVHD).
Methods
An electronic search was carried out on the MEDLINE, EMBASE, Science Citation Index (SCI), and Cochrane Library databases. We included prospective clinical trials in SR-aGVHD treated by ECP. The main endpoints consisted of mortality, exacerbation, or response.
Results
Only seven studies involving 121 patients met the inclusion criteria for further review. Our analysis showed positive results of ECP for aGVHD. The overall response rate (ORR) was 0.71 and the complete response rate (CRR) was 0.71. The efficacy of ECP for skin aGVHD, liver aGVHD, and gut aGVHD were 0.86, 0.60, and 0.68, respectively. However, no sufficient evidence verifies the exact benefit in this review, because the number of patients enrolled in trials is limited and publish bias exists.
Conclusion
ECP is an effective therapy for skin, liver, and gut aGVHD, and large double-blind clinical trials are required to prove the outcome of this meta-analysis.
Acknowledgments
This work was supported by the National Natural Science Foundation of the People’s Republic of China (Grant no 81170492, 81370673), National High Technology Research and Development Program 863 of the People’s Republic of China (Grant no 2012AA022703), National Key Basic Research Program 973 of the People’s Republic of China (Grant no 2010CB732404), Key Medical Projects of Jiangsu Province (Grant no BL2014078), and Key Discipline of Jiangsu Province (2011–2015).
Disclosure
The authors report no conflicts of interest in this work.