Remission rates in patients with refractory skin graft-versus-host disease treated with extracor-poreal photopheresis: a meta-analysis

Objective To systematically analyze therapeutic effects of extracorporeal photopheresis (ECP) on refractory steroid-resistant, -dependent or -intolerant graft-versus-host disease (GVHD) , to compare remission rates of skin GVHD in detail. Methods Databases were searched for studies concerning remission rates of GVHD after the treatment with ECP, and relevant data were extracted and pooled by using meta-analysis with STATA 12.0 software. Results A total of 22 literatures were reviewed, including 787 patients with refractory GVHD. Meta-analysis showed that the pooled complete remission (CR) rate and overall remission (OR) rate were 57% (95% CI: 47%-66%) and 79% (71%-86%) respectively in patients with acute GVHD, 27% (21%-33%) and 63% (58%-69%) respectively in patients with chronic GVHD, 77% (71%-82%) and 87% (82%-91%) in patients with acute skin GVHD, as well as 39% (30%-48%) and 70% (63%-77%) in patients with chronic skin GVHD. Conclusion ECP is an effective therapy for refractory GVHD, especially for skin GVHD. Key words: Graft vs host disease; Skin manifestations; Photopheresis; Meta-analysis; Treatment outcome; Remission rate