Hautmann, Anke H. and Wolff, Daniel and Hilgendorf, Inken and Fehn, Ute and Edinger, Matthias and Hoffmann, Petra and Herr, Wolfgang and Koelbl, Oliver and Holler, Barbara and Sporrer, Daniela and Holler, Ernst and Hautmann, Matthias G. (2015) Total nodal irradiation in patients with severe treatment-refractory chronic graft-versus-host disease after allogeneic stem cell transplantation: Response rates and immunomodulatory effects. RADIOTHERAPY AND ONCOLOGY, 116 (2). pp. 287-293. ISSN 0167-8140,
Full text not available from this repository. (Request a copy)Abstract
Background and purpose: The use of total nodal irradiation (TNI) has been reported as an immunomodulatory therapy for different diseases including chronic graft-versus-host disease (cGVHD). Material and methods: We retrospectively analyzed 13 patients with treatment-refractory cGVHD receiving TNI with 1 x 1 Gy from 2001 to 2014. In 10 of 13 patients immunomodulatory effects of TNI were measured. Results: At time of TNI all patients had severe cGVHD (involving the skin: n = 12), fascia (n = 6), oral mucosa (n = 8), eye (n = 8), and lung (n = 5). Nine of 13 patients had corticosteroid-refractory cGVHD. In 7 of 13 patients (54%) a partial response (PR) could be achieved. In 3 patients (23%) cGVHD manifestations remained stable, 2 patients progressed. One patient was not evaluable due to follow-up <1 month. At 3 months after TNI, best responses could be achieved in skin, and oral involvement including steroid sparing activity. TNI was well tolerated with adverse effects limited to reversible thrombocytopenia and neutropenia. Immunomodulatory effects on peripheral blood cells could be demonstrated including an increase of CD4(+); T cells in the group of responders. Conclusions: TNI represents an effective immunomodulating therapy in treatment-refractory cGVHD. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TOTAL-LYMPHOID IRRADIATION; BONE-MARROW-TRANSPLANTATION; CONSENSUS DEVELOPMENT PROJECT; WORKING GROUP-REPORT; REGULATORY T-CELLS; CHRONIC GVHD; CLINICAL-TRIALS; THORACOABDOMINAL IRRADIATION; ANTITHYMOCYTE GLOBULIN; HODGKINS-DISEASE; Total nodal irradiation; Chronic graft-versus-host disease (GVHD); Corticosteroid-refractory chronic GVHD; Hematopoietic stem cell transplantation; Immunomodulatory therapy; Total lymphoid irradiation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Lehrstuhl für Strahlentherapie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 18 Jun 2019 11:26 |
| Last Modified: | 18 Jun 2019 11:26 |
| URI: | https://pred.uni-regensburg.de/id/eprint/5053 |
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