Retinal toxic reactions following photopheresis.
BACKGROUND
Extracorporeal photochemotherapy (ECP), also known as photopheresis, is a generally well-tolerated therapeutic, immunomodulatory approach successfully used in cutaneous T-cell lymphoma and other diseases produced by T-lymphocytes such as graft vs host disease.


METHODS
On 2 separate occasions, a 54-year-old white man with Sézary syndrome developed cutaneous phototoxic reactions and chorioretinitis after being treated with ECP. A pharmacokinetic study showed therapeutic blood levels of 8-methoxypsoralen as long as 18 weeks after therapy had been terminated. However, the analysis of mutations in genes involved in the drug's disposition could not explain these abnormal levels.


CONCLUSIONS
To our knowledge, there has been no previous description of ECP-related retinal toxic effects. This adverse effect was probably linked to impaired drug elimination. Further studies would be needed to determine the underlying mechanism.
Vagace
Jose Manuel
JM
Department of Hematology, University Hospital Infanta Cristina, Avda Elvas s/n, E-06080 Badajoz, Spain. jvagacev@aehh.org
Gervasini
Guillermo
G
Morais
Fernando
F
Benitez
Julio
J
Alonso
Nieves
N
de Argila
Diego
D
Arranz
Isabel
I
Bajo
Roberto
R
D002825:Chorioretinitis / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D008730:Methoxsalen / Q000493:pharmacokinetics; D008875:Middle Aged; D017893:Photopheresis / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000493:pharmacokinetics; D012751:Sezary Syndrome / Q000097:blood / Q000628:therapy*; D012878:Skin Neoplasms / Q000097:blood / Q000628:therapy*
D017319:Photosensitizing Agents; D008730:Methoxsalen