title: Extracorporeal photopheresis for the treatment of acute and chronic graft-versus-host disease in adults and children: best practice recommendations from an Italian Society of Hemapheresis and Cell Manipulation (SIdEM) and Italian Group for Bone Marrow Transplantation (GITMO) consensus process.
abstract: BACKGROUND
  Extracorporeal photopheresis (ECP) is an effective treatment for both acute and chronic graft-versus-host disease (GVHD) in children and adults. Despite the large use of this treatment, a large heterogeneity in current application of ECP has been reported so far and recent evidence brought novel issues into some specific topics. Consensus-based recommendations ameliorate the appropriateness in daily clinical practice and, in turn, optimize the use of health care resources.
  
  
  METHODS
  Two Italian scientific societies, the Italian Society of Hemapheresis and Cell Manipulation (SIdEM) and the Italian Group for Bone Marrow Transplantation (GITMO), joined to develop and disseminate recommendations on appropriate application of ECP treatment in patients with GVHD. Accordingly, SIdEM and GITMO named an expert panel that first selected 16 questions that were considered relevant for clinical practice: the questions were subsequently addressed through a revision of the available literature and in consensus meetings. The whole group discussed the proposed recommendations according to the nominal group technique.
  
  
  RESULTS
  The above-described approach in turn allowed the panel to agree on 47 practice recommendations. SIdEM and GITMO will disseminate such recommendations to the national transplant centers.
  
  
  CONCLUSIONS
  In conclusion, SIdEM and GITMO have made a scientific effort to provide a useful tool to physicians involved in the field, thus supporting daily clinical practice, as well as strategic decisions in the setting of ECP treatment of GVHD.
authors.affiliation: Servizio di Immunoematologia e Medicina Trasfusionale, A.O. San Camillo-Forlanini, Roma, Italy; Università La Sapienza, Roma, Italy; Servizio Trasfusionale, UOS Aferesi e Nuove Tecnologie Trasfusionali, A.O. San Gerardo, Monza, Italy; Unità di Ematologia, Divisione di Medicina Interna, Ospedale C. Massaia, Asti, Italy; Clinica di Oncoematologia Pediatrica, Università di Padova, Padova, Italy; Servizio di Immunoematologia e Trasfusionale, Unità di Terapia Cellulare, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy; UO Immunoematologia, A. O. Universitaria Pisana, Pisa, Italy; Divisione Ematologia e Trapianto di Midollo Osseo, Ospedale San Martino, Genova, Italy; Dipartimento of Oncologia/Ematologia Pediatrica, IRCCS Ospedale Pediatrico Bambino Gesù, Pavia, Italy; Università di Pavia, Pavia, Italy; Centro Trasfusionale, Ospedale San Martino, Genova, Italy; UO Ematologia, A.O. Careggi and Università di Firenze, Firenze, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pierelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Perseghin
authors.forename: Monia
authors.initials: M
authors.lastname: Marchetti
authors.forename: Chiara
authors.initials: C
authors.lastname: Messina
authors.forename: Cesare
authors.initials: C
authors.lastname: Perotti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mazzoni
authors.forename: Andrea
authors.initials: A
authors.lastname: Bacigalupo
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Carlier
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D032921:Consensus; D006086:Graft vs Host Disease / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008875:Middle Aged; D017893:Photopheresis; D012955:Societies, Medical