Table 1.
Patient | Age/Sex | Primary disease | Hx acute skin GvHD | Hx chronic skin GvHD | cGvHD of other organ systems | Voriconazole dose | Latency between voriconazole initiation and phototoxicity | Concurrent potentially photosensitizing drugs | cGVHD therapy at time of phototoxicity diagnosis | Resolution of phototoxicity |
---|---|---|---|---|---|---|---|---|---|---|
1 | 15/M | Alveolar rhabdomyosarcoma | Yes | Yes | Oral | 200mg BID | 2 weeks | None | Prednisone 8mg QD | 3 weeks |
2 | 6/F | Pre-B cell ALL | Yes | Yes | None | 175mg BID | 6 months | HCTZ | Prednisone 25mg BID Tacrolimus 0.5mg QAM, 0.25 QPM MMF 750mg q12hr Hydrocortisone 2.5% BID (face) Fluocinolone 0.1% BID (body) |
2 weeks |
3 | 40/F | Large B-cell lymphoma | Yes | Yes | Ocular Oral Hepatic |
200mg BID | 42 months | Amitriptyline | Extracorporeal photopheresis Prednisone 40mg QD Fluocinolone solution (scalp) Clobetasol ointment 0.05% (body) Tacrolimus ointment (face) |
Improved in3 days, continued cGvHD flare |
4 | 47/M | CML | Yes | Yes | Ocular Hepatic Pulmonary |
200mg BID | 1 month | None | Prednisone 50mg QOD MMF 1gm q12hr |
4 months |
5 | 59/M | Myeloid metaplasia/myelofibrosis | No | No | Ocular Hepatic Pulmonary |
200mg BID | 3 months | Lisinopril Furosemide |
Prednisone 20mg QOD | 3 months |
Abbreviations: ALL, acute lymphoblastic leukemia; CML, chronic myelogenous leukemia; HCTZ, hydrochlorothiazide; MMF, mycophenolate mofetil