439 Psoralen plus ultraviolet A for acute cutaneous graft versus host disease

Psoralen plus ultraviolet A (PUVA) has immunomodulatory effects through enhancement of Tregactivity, making it a promising steroid-sparing therapy for cutaneous graft versus host disease (GVHD). We performed single-institution, retrospective study 146 patients who underwent an allogenic stem cell transplant (SCT) between 2011-2019, were diagnosed with acute GVHD (aGVHD), and treated at least one session PUVA. Clinical responses defined as complete response (CR): resolution aGVHD; partial (PR): any reduction in clinical grade other than CR; stable (SD); or progressive (PD): increased grade. The median age the cohort was 55y (range 41–62y). Patients aGVHD 24d 6–104d) after SCT, initiated PUVA treatment 52d 13–265d) SCT. 13 treatments over 35 days. During follow-up period (median: 51mo; range 2–123mo from SCT), 92 developed chronic (cGVHD), 63 died. Among ≥ 2 had known (n=135), 47% (n=63) CR, 27% (n=36) PR, 18% (n=24) SD, 9% (n=12) PD. Overall, 60/106 (57%) initially on steroids their steroid dose reduced by 50% (69% vs. 15% CR+PR SD+PD, p<0.001). time to developing cGVHD SCT 32mo group compared 11.9mo SD+PD (p = 0.068). cGVHD-survival 7.3mo 3.2mo groups (P<0.001). Overall survival did not differ significantly 0.70). Adverse events occurred 13%, primarily phototoxicity. Objective may also be associated longer development better cGVHD-free outcomes. Our data supports that effective well-tolerated GVHD.