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Systematic review and meta-analysis of prospective studies for ECP treatment in patients with steroid-refractory acute GVHD

Authors Zhang H, Chen R, Cheng J, Jin N, Chen B

Received 29 October 2014

Accepted for publication 18 November 2014

Published 17 January 2015 Volume 2015:9 Pages 105—111

DOI https://doi.org/10.2147/PPA.S76563

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Johnny Chen

Hongming Zhang, Runzhe Chen, Jian Cheng, Nan Jin, Baoan Chen

Department of Hematology and Oncology (Key Department of Jiangsu Medicine), Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, People’s Republic of China

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.

Keywords: extracorporeal photopheresis, steroid-refractory acute graft-versus-host disease, allogeneic hematopoietic stem cell transplantation

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