Clinical Results of Extracorporeal Photopheresis

Abstract

Extracorporeal photopheresis (ECP) is a combination of leukapheresis and photodynamic therapy in which blood is treated with photoactivable drugs which are then activated with ultraviolet light and re-infused to the patient. It has been used successfully for more than 30 years in the treatment of erythrodermic cutaneous T-cell lymphoma (CTCL) and over 20 years for chronic graft-versus-host disease (GVHD). ECP has also shown promising results in the treatment of acute GVHD and other T-cellmediated diseases, including systemic sclerosis, treatment and prevention of solid organ rejection, and more recently Crohn’s disease. The use of ECP may allow a significant reduction or even discontinuation of corticosteroids and/or other immunosuppressants, thus leading to reduced long-term morbidity and mortality and improved overall survival. ECP is a well-tolerated therapy. No significant side effects have been reported during the last 30 years. It has been shown that ECP is not associated with an increased incidence of infections, malignancies, or recurrence of underlying malignant disease, neither during short-term nor during long-term therapy.

A transition from using multi‐step procedures to a fully integrated system for performing extracorporeal photopheresis: A comparison of costs and efficiencies

“…ECP combines leukapheresis and photodynamic therapy, and can be performed using a multi‐step procedure or using a fully integrated system . The mechanism of photopheresis is not fully understood, however, it is theorized that T‐lymphocyte cells damaged by ultraviolet A (UVA) during the procedure activate the patient's immune system …”

Pharmacological- and non-pharmacological therapeutic approaches in inflammatory bowel disease in adults

“…The bestcharacterized subtypes of Tregs are those expressing CD4 and CD25 [149,150] . It is also suggested that ECP induces IL10 producing regulatory B cells, regulatory CD8 + T cells and IL10 producing Tregs Type 1 [167,169,170] . IL10, also known as cytokinesynthesis inhibitory factor, is a potent anti-inflammatory cytokine [171] .…”

Dermatolojik hastalıkların tedavisinde immunmodülasyon

“…UVA ile ışınlanmış hücreler tekrar hastaya verilir 59 . UVA, lenfositlerde DNA hasarına yol açarak zararlı T-lenfositlerinin hasarlanmasını sağlar 60 . Dermatolojide evre 2-4 kutanöz T hücreli lenfoma tedavisinde 30 yıldır, kronik graft versus host hastalığı tedavisinde 20 yıldır kullanılmaktadır 59 .…”

“…Dermatolojide evre 2-4 kutanöz T hücreli lenfoma tedavisinde 30 yıldır, kronik graft versus host hastalığı tedavisinde 20 yıldır kullanılmaktadır 59 . Akut graft versus host hastalığı, Crohn hastalığı, sistemik skleroz gibi kollajen doku hastalıkları ve otoimmun büllü hastalıklarda da başarıyla kullanıldığını bildiren yayınlar mevcuttur 60 . Etkili ve yan etkiler açısından güvenli bir tedavi seçeneği olan ekstrakorporeal fotoferezin kullanımını sınırlayan en önemli engel, yüksek maliyetidir.…”