Narrow‐band UVB phototherapy for management of oral chronic graft‐versus‐host disease. Issue 2 (13th October 2014)

• Record Type: Journal Article
• Authors: Treister, Nathaniel; Li, Shuli; Lerman, Mark A; Lee, Stephanie; Soiffer, Robert
• Is Part Of: Photodermatology, photoimmunology & photomedicine. Volume 31:Issue 2(2015:)
• Page Start: 75
• Page End: 82
• Publication Date: 2014-10-13
• Subjects: Photosensitivity disorders -- Periodicals; Dermatology -- Periodicals; Immunology -- Periodicals; 616.5
• DOI: 10.1111/phpp.12141
• Languages: English
• ISSNs: 0905-4383

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="phpp12141-sec-0001" sec-type="section"> <title>Objectives</title> <p>Oral chronic graft‐versus‐host disease (cGVHD) is a debilitating complication following allogeneic hematopoietic cell transplantation. The objective of this study was to evaluate the safety and efficacy of intraoral narrow‐band ultraviolet B (NB‐UVB) phototherapy in the management of oral cGVHD.</p> </sec> <sec id="phpp12141-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients with oral cGVHD were treated using a custom NB‐UVB unit for a course of 24 phototherapy sessions. Treatments were initiated at 50 mJ/cm<sup>2</sup> and increased by 10% at each visit unless toxicity was noted. Toxicity and response were assessed weekly.</p> </sec> <sec id="phpp12141-sec-0003" sec-type="section"> <title>Results</title> <p>Eleven patients received a median of 22 (range 4–39) NB‐UVB treatments; 5 patients completed 24 treatments and elected to receive a median of 7 additional treatments. Median symptom scores (0–10) for sensitivity, pain, and dryness at baseline/end of therapy were 7.5, 3, 1, and 3, 1, 2, respectively. Taking into account all patient‐reported outcomes, 7/11 patients had improvement and 2/11 worsened. At least partial improvement was reported in 8/11 patients with none reporting worsening. Overtreatment occurred in 10/11 patients with all graded mild or moderate and resolving in 1–2 days.</p> </sec> <sec id="phpp12141-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Intraoral NB‐UVB may be effective for management of refractory oral cGVHD. Further optimization of treatment parameters, as well as minimal erythema dose testing, and inclusion of a control arm are necessary in the consideration of future studies.</p> </sec> </abstract>