File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)

Conference Paper: Treatment of children with drug-resistant Graft-Versus-Host-Disease by extracorporeal photopheresis

TitleTreatment of children with drug-resistant Graft-Versus-Host-Disease by extracorporeal photopheresis
Authors
KeywordsMedical sciences
Oncology medical sciences
Pediatrics
Issue Date2013
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1545-5017/
Citation
The 45th Congress of the International Society of Paediatric Oncology (SIOP 2013), Hong Kong, China, 25-28 September 2013. In Pediatric Blood & Cancer, 2013, v. 60 S3, p. 183-184, abstract no. P-0559 How to Cite?
AbstractPURPOSE/OBJECTIVE: We reviewed the clinical experience of performing extracorporeal photopheresis (ECP) for the treatment of children with drug-resistant graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation. MATERIALS AND METHODS: This is a retrospective review of children who received ECP at Queen Mary Hospital in Hong Kong since 2011. RESULTS: We performed ECP 79 times (discontinuous flow 16 times and continuous flow 63 times) in 3 children (body weight 26 to 35 kg) who suffered from severe extensive sclerodermatous chronic GVHD with pulmonary fibrosis (patient 1, beta-thalassemia major girl, matched unrelated stem cell transplant), steroid refractory grade 4 acute gut and liver GVHD (patient 2, AML boy, 5/6 HLA-matched unrelated cord blood transplant), and progressive bronchiolitis obliterans (patient 3, AML boy, matched sibling bone marrow transplant) respectively. Blood priming and prior hypertransfusions were required to minimize fluid shifts in these underweight patients. ECP was performed 1-3 times per week. The anticoagulant:blood ratio (heparin saline 20 units/ml) was adjusted according to the patients’ hemostatic status between 8:1 to 12:1. Problems including machine failure possibly caused by poor inlet blood flow, blood clots or air in the circuits were encountered. Transient hypertension and cold sensation had been reported during discontinuous flow but not in continuous flow ECP. There were no adverse hemodynamic events noted. Patient 2 and 3 had significant improvement in their GVHD resulting in reduction of the immunosuppressive drugs. Patient 1 started ECP at a relatively late stage and she died of pulmonary aspergillosis and atypical mycobacterial infection, unrelated to the procedure. CONCLUSIONS: ECP was well tolerated in these underweight patients by using the continuous flow photopheresis system. Technical problems are common and require trained and experienced nurses to perform the procedures. It seems to be an efficacious and safe alternative therapy for drug-resistant severe acute or chronic GVHD.
DescriptionThis journal suppl. entitled: Supplement: SIOP Abstratcs: 45th Congress of the International Society of Paediatric Oncology (SIOP) ... 2013
Poster Session - Nursing: abstract no. P-0559
Persistent Identifierhttp://hdl.handle.net/10722/193633
ISSN
2015 Impact Factor: 2.634
2015 SCImago Journal Rankings: 1.505

 

DC FieldValueLanguage
dc.contributor.authorChiu, SYen_US
dc.contributor.authorChan, HYen_US
dc.contributor.authorShum, SKen_US
dc.contributor.authorCheuk, DKLen_US
dc.contributor.authorChiang, AKSen_US
dc.contributor.authorHa, SYen_US
dc.contributor.authorChan, GCFen_US
dc.date.accessioned2014-01-20T05:11:55Z-
dc.date.available2014-01-20T05:11:55Z-
dc.date.issued2013en_US
dc.identifier.citationThe 45th Congress of the International Society of Paediatric Oncology (SIOP 2013), Hong Kong, China, 25-28 September 2013. In Pediatric Blood & Cancer, 2013, v. 60 S3, p. 183-184, abstract no. P-0559en_US
dc.identifier.issn1545-5009-
dc.identifier.urihttp://hdl.handle.net/10722/193633-
dc.descriptionThis journal suppl. entitled: Supplement: SIOP Abstratcs: 45th Congress of the International Society of Paediatric Oncology (SIOP) ... 2013-
dc.descriptionPoster Session - Nursing: abstract no. P-0559-
dc.description.abstractPURPOSE/OBJECTIVE: We reviewed the clinical experience of performing extracorporeal photopheresis (ECP) for the treatment of children with drug-resistant graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation. MATERIALS AND METHODS: This is a retrospective review of children who received ECP at Queen Mary Hospital in Hong Kong since 2011. RESULTS: We performed ECP 79 times (discontinuous flow 16 times and continuous flow 63 times) in 3 children (body weight 26 to 35 kg) who suffered from severe extensive sclerodermatous chronic GVHD with pulmonary fibrosis (patient 1, beta-thalassemia major girl, matched unrelated stem cell transplant), steroid refractory grade 4 acute gut and liver GVHD (patient 2, AML boy, 5/6 HLA-matched unrelated cord blood transplant), and progressive bronchiolitis obliterans (patient 3, AML boy, matched sibling bone marrow transplant) respectively. Blood priming and prior hypertransfusions were required to minimize fluid shifts in these underweight patients. ECP was performed 1-3 times per week. The anticoagulant:blood ratio (heparin saline 20 units/ml) was adjusted according to the patients’ hemostatic status between 8:1 to 12:1. Problems including machine failure possibly caused by poor inlet blood flow, blood clots or air in the circuits were encountered. Transient hypertension and cold sensation had been reported during discontinuous flow but not in continuous flow ECP. There were no adverse hemodynamic events noted. Patient 2 and 3 had significant improvement in their GVHD resulting in reduction of the immunosuppressive drugs. Patient 1 started ECP at a relatively late stage and she died of pulmonary aspergillosis and atypical mycobacterial infection, unrelated to the procedure. CONCLUSIONS: ECP was well tolerated in these underweight patients by using the continuous flow photopheresis system. Technical problems are common and require trained and experienced nurses to perform the procedures. It seems to be an efficacious and safe alternative therapy for drug-resistant severe acute or chronic GVHD.-
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1545-5017/-
dc.relation.ispartofPediatric Blood & Canceren_US
dc.subjectMedical sciences-
dc.subjectOncology medical sciences-
dc.subjectPediatrics-
dc.titleTreatment of children with drug-resistant Graft-Versus-Host-Disease by extracorporeal photopheresisen_US
dc.typeConference_Paperen_US
dc.identifier.emailChan, HY: hoiyanc@hku.hken_US
dc.identifier.emailCheuk, DKL: klcheuk@hkucc.hku.hken_US
dc.identifier.emailChiang, AKS: chiangak@hku.hken_US
dc.identifier.emailHa, SY: syha@hku.hken_US
dc.identifier.emailChan, GCF: gcfchan@hku.hken_US
dc.identifier.authorityChiang, AKS=rp00403en_US
dc.identifier.authorityChan, GCF=rp00431en_US
dc.identifier.doi10.1002/pbc.24719-
dc.identifier.hkuros227226en_US
dc.identifier.volume60-
dc.identifier.issueS3-
dc.identifier.spage183-
dc.identifier.epage184-
dc.publisher.placeUnited States-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats