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Hautarzt 2019 Jan 9. Epub 2019 Jan 9.

Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Ruprecht-Karls-Universität Heidelberg, Mannheim, Deutschland.

Background: Extracorporal photopheresis (ECP) was shown to be effective without severe side effects in the treatment of cutaneous T cell lymphoma (CTCL) and graft versus host disease (GvHD). However, only few studies investigated the practical aspects of ECP.

Methods: Treatment protocols of 2038 ECP procedures in 52 patients (CTCL, n = 29; GvHD, n = 15; other, n = 8) were evaluated. Read More

Transplant Proc 2018 Dec 4;50(10):3906-3910. Epub 2018 May 4.

Organ Transplantation Institute, Beijing Key Laboratory of Organ Transplantation and Immune Regulation, 309th Hospital of the Chinese People's Liberation Army, Beijing, China. Electronic address:

Extracorporeal photopheresis (ECP) represents an alternative to immunosuppression as a means of reducing rejection after thoracic organ transplantation. The mechanism by which ECP exerts its protective effects, until now, has remained elusive. Infusion of ECP-treated splenic lymphocytes (PUVA-SP) can induce CD4CD25Foxp3 regulatory T cells. Read More

Urologiia 2018 Dec(5):28-34

The surgical department of transplantation and dialysis of GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia.

Aim: to evaluate the influence of prophylactic use of photopheresis on the risk of long-term infective complications after kidney transplantation.

Materials And Methods: The open cohort randomized study was conducted. A total of 60 recipients after cadaveric kidney allotransplantation from 30 donors were assessed. Read More

J Clin Apher 2018 Dec 14. Epub 2018 Dec 14.

Hemathology and Hemotherapy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Background: Extracorporeal photopheresis (ECP) is an efficient and established therapy to treat acute and chronic graft vs host disease (GVHD). Using an "off-line" method, the first step (mononuclear cell [MNC] collection) is decisive, as long as a high MNC yield and purity in the collected product is desirable. Two "off-line" devices were compared: the COBE Spectra and the Spectra Optia (Terumo BCT), using both continuous and intermittent protocols. Read More

J Clin Apher 2018 Dec 12. Epub 2018 Dec 12.

Division of Laboratory Medicine, Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama.

Many vascular access options, such as subcutaneous ports, are currently on the market for use in both medication infusion and for procedures, such as therapeutic plasma exchange and extracorporeal photopheresis. We compared the cost and time necessary to complete apheresis procedures using either Angiodynamic's Vortex or Bard's PowerFlow subcutaneous ports by reviewing our experience on two patients undergoing long-term apheresis treatments with at least 10 procedures with each type of port. We analyzed the cost of needles and thrombolytic therapy, staff time, overall procedure length, and the total time the patient was in the apheresis unit. Read More

J Clin Apher 2019 Feb 10;34(1):73-74. Epub 2018 Nov 10.

Photopheresis, Rotherham Foundation Trust, Rotherham, United Kingdom.

Extracorporeal photopheresis (ECP) is a cell based immunomodulatory therapy in which the patient is attached intravenously to a cell separating machine. During ECP a patient's blood is collected via either a central venous access device (CVAD) or a peripherally inserted 16G arterial venous fistula needle in either one or both antecubital fossa. However, patients presenting for ECP with GVHD repeatedly present a challenge to the ECP team due to poor venous access resulting from previous therapies and skin changes. Read More

Clin Exp Immunol 2019 Mar 22;195(3):369-380. Epub 2018 Nov 22.

Tuebingen University Children's Hospital, Department of Hematology and Oncology, Tuebingen, Germany.

Extracorporeal photopheresis (ECP) is a widely used immunomodulatory therapy for the treatment of various T cell-mediated disorders such as cutaneous T cell lymphoma (CTCL), graft-versus-host disease (GvHD) or systemic sclerosis. Although clinical benefits of ECP are already well described, the underlying mechanism of action of ECP is not yet fully understood. Knowledge on the fate of CD14 monocytes in the context of ECP is particularly limited and controversial. Read More

J Clin Apher 2018 Dec 5;33(6):654-660. Epub 2018 Nov 5.

Hematology Department and BMT Unit, George Papanicolaou Hospital, Thessaloniki, Greece.

Background: Graft vs host disease (GVHD) is the most severe complication of allogeneic hematopoietic cell transplantation. Conventional immunosuppressive therapy increases morbidity and mortality without improving survival. Extracorporeal photopheresis (ECP) has been introduced as an alternative treatment in steroid-dependent and steroid-refractory disease. Read More

Vox Sang 2018 Nov 23;113(8):803-810. Epub 2018 Oct 23.

Department of Transfusion Medicine, University Medical Center Göttingen, Göttingen, Germany.

Background And Objective: Extracorporeal photopheresis (ECP) is an important immune tolerance inducing therapy for graft-versus-host disease (GvHD). However, a sufficient number of ECP cycles cannot be performed in patients with severe GvHD and contraindications for apheresis. Allogeneic sources of leucocytes for use as ECP treatment would be of great benefit. Read More

Front Immunol 2018 8;9:2207. Epub 2018 Oct 8.

Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany.

Graft-vs.-host disease (GvHD), a severe complication of allogeneic hematopoietic stem cell transplantation, significantly affects the post-transplant morbidity and mortality. Systemic steroids remain the gold standard for the initial management of GvHD. Read More

J Clin Apher 2018 Dec 15;33(6):682-684. Epub 2018 Oct 15.

Department of Pathology and Laboratory Medicine, Phoenix Children's Hospital, Phoenix, Arizona.

Transfusion 2018 Dec 12;58(12):2933-2941. Epub 2018 Oct 12.

Department of Pathology & Immunology, Division of Laboratory & Genomic Medicine, Washington University School of Medicine, St Louis, Missouri.

Background: The most common instruments used for extracorporeal photopheresis (ECP) treatment in the United States are the UVAR XTS and the CELLEX devices (Therakos, West Chester, PA). When compared to the UVAR XTS instrument, the efficacy of the CELLEX instrument to arrest the decline in lung function in patients with chronic lung allograft dysfunction (CLAD) related to bronchiolitis obliterans (BOS) has not been previously evaluated.

Methods: The relative efficacy of the CELLEX vs UVAR XTS ECP instruments was assessed by comparing the difference in rates of FEV decline before and after ECP treatment and survival in two series of lung allograft recipients with BOS who had been treated with these instruments. Read More

Transfusion 2018 Nov 6;58(11):2495-2500. Epub 2018 Oct 6.

Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University, Giessen, Germany.

Background: Extracorporeal photopheresis (ECP) has been established to treat graft-versus-host disease. Our mini ECP technique (mini-ECP) allows for treatment of patients with GVHD and contraindications for classical ECP or low body weight. The safety and efficacy of applying ECP for the long-term treatment of chronic GVHD (cGVHD) have not been described. Read More

Transfusion 2019 Jan 4;59(1):340-346. Epub 2018 Oct 4.

Blood Transfusion & Therapeutic Apheresis Unit, Hematology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.

Background: Extracorporeal photopheresis (ECP) is an effective treatment. However, protocols differ widely, and some questions, such as the number of cells to be collected or the number of ECP treatment days per treatment cycle, are still unsolved. The aim of this study was to compare a multistep (offline) (Spectra Optia and Macogenic G2) against an integrated (inline) ECP system (Therakos Cellex system) with respect to mononuclear cell (MNC) collection. Read More

Transfusion 2018 Dec 27;58(12):2924-2932. Epub 2018 Sep 27.

Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, Murcia, Spain.

Background: CD56 natural killer (NK) regulatory cells were recently shown to display a differential impact on the risk of developing extensive chronic graft-versus-host disease (GVHD). To date no study has definitively established which immune populations are most responsible for the immunomodulatory effects or response to extracorporeal photopheresis (ECP) for GVHD.

Study Design And Methods: To test the role of CD56 NK cells in ECP, a prospective enhanced flow cytometry follow-up of immune subsets (CD19+, CD3+, CD3+/CD4+, CD3+/CD8+, CD3-/CD56+, CD3-/CD56 , and CD3-/CD56 ) was performed in 32 patients with GVHD who underwent 552 procedures. Read More

Photodermatol Photoimmunol Photomed 2019 Jan 17;35(1):51-53. Epub 2018 Oct 17.

Department of Dermatology, Medical University of Vienna, Vienna, Austria.

Best Pract Res Clin Haematol 2018 Sep 18;31(3):322-335. Epub 2018 Jul 18.

City of Hope National Medical Center, Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA. Electronic address:

Novel systemic therapies are generally prescribed to patients with advanced-stage disease or those with early-stage disease refractory to skin-directed therapies. In general, systemic chemotherapy should be reserved for patients who fail to respond to biological agents. Such biological agents include interferon alfa, bexarotene, histone deacetylase inhibitors (vorinostat, romidepsin), brentuximab vedotin and mogamulizumab. Read More

Front Med (Lausanne) 2018 27;5:236. Epub 2018 Aug 27.

Department of Dermatology, Medizinische Universität Wien, Vienna, Austria.

Extracorporeal photopheresis (ECP) has been in clinical use for over three decades after receiving FDA approval for the palliative treatment of the Sézary Syndrome variant of cutaneous T-cell lymphoma (CTCL) in 1988. After the first positive experiences with CTCL, additional indications have been successfully explored including areas such as graft-vs.-host disease (GVHD), scleroderma, and solid organ transplantation. Read More

Transfusion 2018 09;58(9):2095-2101

Divisions of Pathology & Laboratory Medicine, Children's National Health System, Washington, DC.

Transfus Apher Sci 2018 10 4;57(5):689. Epub 2018 Sep 4.

Immunohaematology and Transfusion Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Transplant Proc 2018 Sep 14;50(7):2218-2222. Epub 2018 Mar 14.

Department of Hematology, Oncology, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.

Background: There are only a few cases of pericarditis complications following allogeneic bone marrow transplantation described in the literature and there are no data available on the risk and frequency of this condition. The aim of this study was to assess the frequency of exudative pericarditis complicating chronic graft-vs-host disease in allogeneic hematopoietic cell transplant recipients.

Methods: Retrospective analysis involved a group of 105 patients of the Outpatient Transplantation Service of the Department of Hematology, Medical University of Warsaw, who received transplants in the years 2010-2016 and were evaluated for the years 2014-2016. Read More

J Clin Apher 2018 Oct 3;33(5):591-599. Epub 2018 Sep 3.

Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.

Background: The clinical use of extracorporeal photopheresis (ECP) is based on its ability to induce cell-mediated immune tolerance towards foreign and self-antigens. Up-to-date, no clear consensus consists on how to use ECP after heart transplantation (HTx). In this pilot study, we evaluated the stimulatory effects of ECP on immune cells in HTx patients. Read More

Transplantation 2018 Aug 20. Epub 2018 Aug 20.

Washington University School of Medicine, Department of Pathology & Immunology, Division of Laboratory & Genomic Medicine, Department of Anesthesiology, Division of Cardiothoracic Anesthesiology.

Background: This study was designed to identify factors associated with clinical response to extracorporeal photopheresis (ECP) and mortality after ECP in lung allograft recipients with bronchiolitis obliterans (BOS).

Methods: FEV1 values obtained 6 months before (baseline) and 6 months after initiation of ECP were used to plot the linear relationship between FEV1 vs time before and after ECP. Response to ECP was assigned when a positive integer was derived after subtracting the baseline rate of decline from the rate of decline 6 months after ECP. Read More

Bone Marrow Transplant 2018 Jul 23. Epub 2018 Jul 23.

Division of Hematology and Stem Cell Transplant, King Faisal Specialist Hospital, Riyadh, Saudi Arabia.

The incidence of bronchiolitis obliterans syndrome (BOS), a devastating manifestation of chronic graft-versus-host-disease, may rise globally due to steady increases in utilization of allogeneic hematopoietic cell transplantation (HCT). Though some advances have occurred in the past decade regarding understanding of the pathogenesis, diagnosis and treatment of BOS, the overall mortality and morbidity remain very high. We sought to determine the current diagnostic and therapeutic challenges, which can potentially hinder optimal management of BOS both in developed and developing countries. Read More

Dermatopathology (Basel) 2018 Apr-Jun;5(2):69-73. Epub 2018 May 25.

Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland.

Sign of Leser-Trélat is a rare paraneoplastic cutaneous manifestation, characterized by the sudden appearance and rapid increase in size and number of seborrheic keratoses, accompanied by pruritus. Edmund Leser and Ulysse Trélat described this sign in 1890. Since their first description, their conclusions have been considered controversial and some authors assert the absence of a causal link. Read More

JAAD Case Rep 2018 Jun 30;4(5):443-445. Epub 2018 Apr 30.

The Department of Dermatology, Yale University, New Haven, Connecticut.

Biol Blood Marrow Transplant 2018 Dec 5;24(12):2373-2380. Epub 2018 Jul 5.

Department of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address:

Extracorporeal photopheresis (ECP) is an accepted treatment for chronic graft-versus-host disease (cGVHD); however, the mechanism of action is unclear. We conducted a prospective multicenter clinical trial to assess ECP response rates using the 2005 National Institutes of Health (NIH) consensus criteria and to assess the relationship between regulatory T cells (Tregs) and treatment response (NCT01324908). Eighty-three patients with any NIH subtype of cGVHD were enrolled, irrespective of number of prior lines of treatment, and 6 were subsequently excluded because of the absence of follow-up from cancer relapse, infection, or study withdrawal. Read More

Int J Hematol 2018 Sep 29;108(3):298-305. Epub 2018 Jun 29.

Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.

There are few established therapies for chronic graft-versus-host disease (cGVHD) refractory to first-line treatment with steroids. We evaluated the efficacy and safety of extracorporeal photopheresis (ECP) with a third-generation TC-V device in Japanese patients with cGVHD. Fifteen patients with steroid-resistant or -intolerant cGVHD after allogeneic hematopoietic stem cell transplantation participated in this multicenter open-label study. Read More

Lab Med 2019 Jan;50(1):29-33

Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA.

Objective: To describe the indicidence and severity of iron deficiency anemia (IDA) in patients who have received extracorporeal photopheresis (ECP) treatment of cutaneous T-cell lymphoma (CTCL).

Methods: We performed a retrospective study during a 9-year period of patients with CTCL who were treated with ECP. ECP was performed with UVAR XTS and CELLEX (Therakos Inc). Read More

Haematologica 2018 Nov 28;103(11):1915-1924. Epub 2018 Jun 28.

University of Minnesota, Minneapolis, MN.

Initial therapy of chronic graft--host disease is prednisone ± a calcineurin-inhibitor, but most patients respond inadequately. In a randomized, adaptive, phase II/III, multicenter trial we studied whether prednisone/sirolimus or prednisone/sirolimus/photopheresis was more effective than prednisone/sirolimus/calcineurin-inhibitor for treating chronic graft--host disease in treatment-naïve or early inadequate responders. Primary endpoints of this study were proportions of subjects alive without relapse or secondary therapy with 6-month complete or partial response in phase II, or with 2-year complete response in phase III. Read More

Bone Marrow Transplant 2018 Jun 15. Epub 2018 Jun 15.

Department of Haematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Transfus Apher Sci 2018 Jun 9;57(3):421. Epub 2018 May 9.

Department of Transfusion Medicine and Division of Hematology and Stem Cells Transplanation, City of Hope National Cancer Center, Duarte, CA, USA.

Dermatology 2018 22;234(1-2):23-30. Epub 2018 May 22.

Dermatology Department, University Hospital and Paul Sabatier University of Toulouse, Toulouse, France.

Background: Extracorporeal photopheresis (ECP) is a second-line therapy for steroid-refractory chronic graft-versus-host disease (cGVHD).

Objective: We describe the long-term efficacy and tolerability of ECP according to the cutaneous phenotype of cGVHD and report on the reduced need for immunosuppressant drugs in this setting.

Patients And Methods: Fourteen patients (8 females) with cutaneous and/or mucosal cGVHD, treated with ECP between October 2010 and May 2016 within a single center, were included. Read More

Transfus Apher Sci 2018 Jun 9;57(3):428-430. Epub 2018 May 9.

Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran; Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Tehran, Iran.

Hematopoietic stem cell transplantation is a curative treatment for many hematologic malignancies with its most important side effect being graft-versus-host disease (GVHD). Herein, we present a 3.5 year-old male with weight of 9. Read More

Transfus Apher Sci 2018 Jun 16;57(3):378-383. Epub 2018 May 16.

International Consultancy in Blood Components Quality/Safety improvement, Audit/Inspection, and DDR Strategies, London, UK.

Clinical practice and related diagnostic, development and research [DDR] strategies in pediatric transfusion and transplantation cover a broad range of multidisciplinary studies, performed by many professionals involved in this most challenging clinical field [1]. This commentary on the current position and future perspectives in pediatric transfusion field is aimed to highlight major unresolved transfusion complications in pediatric patients, namely red blood cell and platelet alloimmunisation, and new ones such as nosocomial infection, thrombosis and multi-organ failure. Some other safety related issues issues in clinical management of neonates/young infants with urgent medical conditions, requiring immediate transfusion or apheresis treatment, especially, those resulting from hematopoietic stem cell transplantation (HSCT), have been addressed. Read More

Leuk Res Rep 2018 1;9:72-75. Epub 2018 May 1.

Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA.

Posttransplant lymphoproliferative disorders (PTLDs) of T-cell orgin are rare biologically heterogeneous diseases of mature lymphoid cells manifesting in immunosuppressed patients. Only a few cases of mycosis fungoides diagnosed post allogeneic hematopoietic cell transplant (alloHSCT) have been described so far. We present a patient with myelodysplastic syndrome (MDS) post matched unrelated donor alloHSCT who was on long-term immunosuppressive therapy due to graft versus host disease. Read More

Br J Nurs 2018 May;27(9):488-492

Consultant Haematologist and Director of Photopheresis Unit, The Rotherham NHS Foundation Trust, Rotherham.

Acute graft v host disease (AGVHD) is the main complication and cause of non-relapse mortality following allogenic hematopoietic stem cell transplantion. It occurs when donor immune cells attack host tissues. The three main organs that AGVHD affects are skin, liver and gastrointestinal tract, with one or more organs being involved. Read More

Bone Marrow Transplant 2018 May 8. Epub 2018 May 8.

Department of Hematology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, CopenhagenØ, 2100, Denmark.

Improvement in chronic graft vs. host disease (cGvHD) following treatment with extracorporeal photopheresis (ECP) has been shown previously. However, the effect is often measured at only one point in time or as best response. Read More

J Clin Apher 2018 Aug 7;33(4):461-463. Epub 2018 May 7.

Department of Pathology and Laboratory Medicine, Department of Veterans Affairs, White River Junction, Vermont.

Transfusion 2018 08 29;58(8):1973-1979. Epub 2018 Apr 29.

Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.

Background: Steroid-refractory acute graft-versus-host disease (aGVHD) is a serious complication after hematopoietic stem cell transplantation. The long-term outcome of the patients is poor. Various immunosuppressive agents have been proposed as the second-line therapy but none of them has turned out more effective than the others. Read More

Biol Blood Marrow Transplant 2018 Sep 18;24(9):1906-1913. Epub 2018 Apr 18.

Division of Hematology, Mayo Clinic, Rochester, Minnesota. Electronic address:

We carried out the first matched retrospective cohort study aimed at studying the safety and efficacy of extracorporeal photopheresis (ECP) for bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic cell transplantation (HCT). Medical records of 1325 consecutive adult patients who underwent HCT between 2005 and 2015 were reviewed. Seventy-four patients (median age, 51 years) with a diagnosis of BOS were included in the study. Read More

Transplantation 2018 Aug;102(8):1279-1283

Department of Surgery, University Hospital Regensburg, Regensburg, Germany.

Expert Rev Clin Immunol 2018 04 11;14(4):297-306. Epub 2018 Apr 11.

b Primary Immunodeficiency Group, Institute of Cellular Medicine , Newcastle University , Newcastle upon Tyne , UK.

Introduction: Primary immunodeficiencies (PID) are genetic immune disorders causing increased predisposition to infections and autoimmunity. The only curative procedure is hematopoietic stem cell transplantation (HSCT), results from which have improved dramatically since 2000. Complications remain a serious issue, especially in HLA non-identical transplantation. Read More

Rev Med Suisse 2018 Mar;14(600):699-702

Service de dermatologie et vénéréologie, HUG, 1211 Genève 14.

During the treatment of extracorporeal photopheresis (ECP), white blood cells are collected by apheresis and exposed to ultraviolet A after incubation with 8-methoxypsoralen. Although ECP was first developed for cutaneous T cell lymphoma, it has shown promising efficacy in a number of other serious conditions, like acute and chronic graft-versus-host disease, lung and cardiac transplant rejection and other autoimmune diseases. The ECP has been used for thirty years in some specialized centers but remains unknown to most of the physicians. Read More

J Clin Apher 2018 Aug 25;33(4):464-468. Epub 2018 Mar 25.

Department of Pediatric Hematology/Oncology/Neuro-oncology/Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois.

Stimulated by the scientific progress in deciphering the principal elements contributing to the clinical efficacy of extracorporeal photochemotherapy (ECP), the American Council on ECP (ACE) was formed, under the auspices of the American Society for Apheresis (ASFA), to develop a field-guiding Consensus Report. ACE is composed of thirty nationally recognized ECP experts, clinically spanning cancer, transplantation, and autoimmunity and scientifically bridging immunology, bioengineering, and hematology. The two-day meeting took place in Manhattan, April 13-14, 2017, and unanimous consensus on nine pivotal points is herein reported. Read More

Curr Oncol Rep 2018 03 23;20(4):32. Epub 2018 Mar 23.

Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.

Purpose Of Review: Cutaneous T-cell lymphoma (CTCL) is a rare form of non-Hodgkin lymphoma. Globally, the most common subtypes of CTCL are mycosis fungoides and Sézary syndrome. CTCL can confer significant morbidity and even mortality in advanced disease. Read More

Transplantation 2018 07;102(7):1059-1065

Institute of Cellular Medicine, Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.

Background: Lung transplantation is a therapeutic option for select patients with end-stage lung disease. However, successful lung transplantation is hampered by chronic lung allograft dysfunction, in particular bronchiolitis obliterans syndrome (BOS). Although there is no approved or standard treatment for BOS, which may have several distinct phenotypes, extracorporeal photopheresis (ECP) has shown promising results in patients who develop BOS refractory to azithromycin treatment. Read More

Biol Blood Marrow Transplant 2018 Sep 14;24(9):1920-1927. Epub 2018 Mar 14.

Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. Electronic address:

Given the increasing incidence of chronic graft-versus-host disease (cGVHD) and its rapidly escalating costs due to many lines of drug treatments, we aimed to perform a meta-analysis to assess the comparative effectiveness of various treatment options. Using these results, we then conducted a cost-effectiveness analysis for the frequently utilized agents in steroid-refractory cGVHD. We searched for studies examining tacrolimus, sirolimus, rituximab, ruxolitinib, hydroxychloroquine, imatinib, bortezomib, ibrutinib, extracorporeal photopheresis, pomalidomide, and methotrexate. Read More

Rev Med Interne 2018 May 12;39(5):360-363. Epub 2018 Mar 12.

Service de médecine interne, hôpital Victor-Provo, 11, boulevard Lacordaire, 59170 Roubaix, France.

Background: Scleredema adultorum (Buschke's scleredema) is a cutaneous mucinosis of unknown origin, clinically characterized by a diffuse induration of the skin usually involving the neck, shoulders and back, which limits patients' mobility.

Case Report: We report a case of a 50-year-old woman who presented a chronic sclerodermiform syndrome for 2 years associated with type 1 diabetes. Physical examination revealed an extensive skin induration involving the shoulders, neck and back. Read More

Transfus Apher Sci 2018 Feb 21;57(1):115-117. Epub 2018 Feb 21.

Immunohaematology and Transfusion Service, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.

Renal rejection clinically represents a major cause of graft dysfunction and sadly the loss of the renal transplant. This is despite the considerable progress in immunosuppressive therapy. It is strongly believed that the complex immunologic network underlying the response against major histocompatibility molecules (MHC) is responsible for rejection, an unresolved issue that is, in part, not inhibited by the current prophylactic and therapeutic strategies. Read More