Desafíos y aprendizaje: primera experiencia de fotoféresis en un niño con enfermedad de injerto contra receptor

Abstract

Graft-versus-Host Disease (GVHD) is a serious and common complication following allogeneic hematopoietic stem cell transplants (allo-HSCT), accounting for approximately 25% of post-transplant deaths. Its incidence, which has increased over the past two decades, reaches around 50% in patients undergoing allogeneic hematopoietic progenitor cell transplants. Factors such as patient age, the use of unrelated donors, reduced-intensity regimens, and specific sources of stem cells contribute to this increase. Initial treatment involves corticosteroids and calcineurin inhibitors, but in refractory cases, extracorporeal photopheresis (ECP) emerges as an option. Clinical case: We present the case of a pediatric patient undergoing haploidentical allogeneic hematopoietic progenitor cell transplant for severe aplastic anemia, who subsequently developed severe refractory chronic GVHD, with severe liver, skin and mild lung involvement, who underwent extracorporeal photopheresis sessions as part of the second line of GVHD treatment, with a partial response. Conclusion: the approach and treatment of GVHD results in the impossibility of a single treatment for all patients with this pathology.