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KMID : 1040120170030010028
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Evidence and Values in Healthcare
2017 Volume.3 No. 1 p.28 ~ p.38
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Extracorporeal photopheresis for graft-versus-host disease: A systematic review
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Kim Jin-Hyeong
Choi Won-Jung
Kim Seok-Hyun
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Abstract
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Objectives: The aim of this systematic review was to evaluated the safety and effectiveness of extracorporeal photopheresis (ECP) treatment in patients with steroid-refractory acute or chronic graft-versus-host disease (GVHD).
Methods: The literature review for ECP for GVHD was done using 8 Korea database, Ovid-MEDLINE and Ovid-EMBASE. These databases were systematically searched from 1948 until Jan 2016. A total of 54 articles were included in the final assessment by two reviewers.
Results: There was no serious infection nor catheter-related infection after ECP. Because reported adverse effects were common cases occurring in other invasive procedures. When the survival rate was analyzed according to response, the rate was 59~100% for response patients and 11~30% for non-response patients. Five articles reported an increase in Lansky/Karnofsky performance score from 50~70% to 80~90% when comparing the time before and after ECP.
Conclusion: The overall survival rate and quality of life of response patients reported higher than non-response patients. Reported adverse effects were acceptable safety level at the hospital using ECP. Therefore, ECP is safe and effective technique for patients who do not positive response traditional treatment.
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KEYWORD
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Acute graft-versus-host disease, Chronic graft-versus-host disease, Extracorporeal photopheresis, Safety, Effectiveness
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