National Institutes of Health State of the Science Symposium in Therapeutic Apheresis: Scientific Opportunities in Extracorporeal Photopheresis

Ratcliffe, Nora R.; Dunbar, Nancy M.; Adamski, Jill; Couriel, Daniel R.; Edelson, Richard L.; Kitko, Carrie L.; Levine, John E.; Morgan, Shanna; Schneiderman, Jennifer; Sloan, Steve; Wu, Yanyun; Szczepiórkowski, Zbigniew M.; Cooling, Laura

doi:10.1016/j.tmrv.2014.09.004

Cited by 29 publications

(21 citation statements)

References 137 publications

(157 reference statements)

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“…Adverse effects of ECP treatment are minimal and predominantly related to central venous access. The mechanistic actions of ECP have not been fully elucidated but likely immune-modulate adaptive and innate immunity, predominantly acting through DCs and Tregs (88, 89). …”

Section: Extracorporeal Photopheresis (Ecp)mentioning

confidence: 99%

Treatment of Pediatric Acute Graft-versus-Host Disease—Lessons from Primary Immunodeficiency?

Flinn

Gennery

2017

Front. Immunol.

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Allogeneic hematopoietic stem cell transplant (HSCT) is used to treat increasing numbers of malignant and non-malignant disorders. Despite significant advances in improved human leukocyte antigens-typing techniques, less toxic conditioning regimens and better supportive care, resulting in improved clinical outcomes, acute graft-versus-host disease (aGvHD) continues to be a major obstacle and, although it principally involves the skin, gastrointestinal tract, and liver, the thymus is also a primary target. An important aim following HSCT is to achieve complete and durable immunoreconstitution with a diverse T-cell receptor (TCR) repertoire to recognize a broad range of pathogens providing adequate long-term adaptive T-lymphocyte immunity, essential to reduce the risk of infection, disease relapse, and secondary malignancies. Reconstitution of adaptive T-lymphocyte immunity is a lengthy and complex process which requires a functioning and structurally intact thymus responsible for the production of new naïve T-lymphocytes with a broad TCR repertoire. Damage to the thymic microenvironment, secondary to aGvHD and the effect of corticosteroid treatment, disturbs normal signaling required for thymocyte development, resulting in impaired T-lymphopoiesis and reduced thymic export. Primary immunodeficiencies, in which failure of central or peripheral tolerance is a major feature, because of intrinsic defects in hematopoietic stem cells leading to abnormal T-lymphocyte development, or defects in thymic stroma, can give insights into critical processes important for recovery from aGvHD. Extracorporeal photopheresis is a potential alternative therapy for aGvHD, which acts in an immunomodulatory fashion, through the generation of regulatory T-lymphocytes (Tregs), alteration of cytokine patterns and modulation of dendritic cells. Promoting normal central and peripheral immune tolerance, with selective downregulation of immune stimulation, could reduce aGvHD, and enable a reduction in other immunosuppression, facilitating thymic recovery, restoration of normal T-lymphocyte ontogeny, and complete immunoreconstitution with improved clinical outcome as the ability to fight infections improves and risk of secondary malignancy or relapse diminishes.

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Section: Extracorporeal Photopheresis (Ecp)mentioning

confidence: 99%

Treatment of Pediatric Acute Graft-versus-Host Disease—Lessons from Primary Immunodeficiency?

Flinn

Gennery

2017

Front. Immunol.

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“…60 The American Society for Apheresis also categorized ECP as an accepted first-line therapy for erythrodermic MF/SS as a primary stand-alone treatment or in conjunction with other modes of treatment. 61 …”

Section: Erythrodermic Mycosis Fungoides and Sé Zary Syndromementioning

confidence: 99%

Extracorporeal Photopheresis in the Treatment of Mycosis Fungoides and Sézary Syndrome

Zic

2015

Dermatologic Clinics

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Extracorporeal photopheresis (ECP) is an immunomodulating procedure that leads to an expansion of peripheral blood dendritic cell populations and an enhanced TH1 immune response in cutaneous T-cell lymphoma (CTCL). Because of its excellent side effect profile and moderate efficacy, ECP is considered first-line therapy for erythrodermic mycosis fungoides (MF) and Sézary syndrome. Patients with a measurable but low blood tumor burden are most likely to respond to ECP, and the addition of adjunctive immunostimulatory agents may also increase response rates. There may be a role for ECP in the treatment of refractory early stage MF, but data are limited.

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“…Off‐line ECP is based on MNC collection by apheresis and reinfusion of the cells, previously irradiated in presence of 8‐methoxypsoralen, to the patient. ECP mechanism of action is not completely understood but it probably involves white blood cell (WBC) apoptosis, change in dendritic cell generation, production of cytokines, and T reg induction . Contaminating cells in the apheresis collection product (granulocytes, red blood cells [RBCs], and platelets [PLTs]) may be responsible for side effects during MNC reinfusion to the patient .…”

mentioning

confidence: 99%

Comparison of two automated mononuclear cell collection systems in patients undergoing extracorporeal photopheresis: a prospective crossover equivalence study

et al. 2016

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National Institutes of Health State of the Science Symposium in Therapeutic Apheresis: Scientific Opportunities in Extracorporeal Photopheresis

Cited by 29 publications

References 137 publications

Treatment of Pediatric Acute Graft-versus-Host Disease—Lessons from Primary Immunodeficiency?

Treatment of Pediatric Acute Graft-versus-Host Disease—Lessons from Primary Immunodeficiency?

Extracorporeal Photopheresis in the Treatment of Mycosis Fungoides and Sézary Syndrome

Comparison of two automated mononuclear cell collection systems in patients undergoing extracorporeal photopheresis: a prospective crossover equivalence study

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