[Photochemotherapy (PUVA) of acute graft-versus-host disease]

For several years, psoralen and UV-A light (PUVA) therapy has been used in the treatment of chronic graft-versus-host disease (GvHD) following allogeneic bone marrow transplantation (BMT). There is little experience with PUVA treatment of acute GvHD. Allogeneic BMT was performed in 25 patients, 10 of whom developed acute GvHD despite immunosuppressive therapy. Six patients with acute cutaneous GvHD grade II-III (n = 2 grade II, n = 4 grade III) were treated with PUVA. We present the results. All the PUVA-treated patients improved markedly after 5-12 sessions of irradiation. In 5 patients the skin cleared completely with 8-18 treatments. In 4 patients chronic GvHD was prevented by maintenance treatment for up to 10 months. Following clearing of acute cutaneous GvHD, 2 patients developed chronic GvHD after therapy-free intervals of 3 and 12 months, respectively. These results indicate a beneficial effect of PUVA in acute cutaneous GvHD and suggest a protective effect against chronic GvHD.