Extracorporeal photopheresis: technique, established and novel indications.
Extracorporeal photopheresis (ECP) has had a major impact in the treatment of various conditions in the past 25 years. Although it was initially developed for the treatment of patients with resistant cutaneous T cell lymphoma (CTCL), this therapy was later used to treat recipients of solid organs and stem cell transplants with rejection or graft-versus-host disease (GVHD), respectively. A significant number of patients with CTCL can achieve long term remission with ECP therapy. Those patients with heart or lung transplants may experience fewer or shorter rejection episodes following ECP. Furthermore, patients that respond to ECP can generally reduce the dose of immunosuppression medication, thus minimizing the morbidity caused by drugs such as corticosteroids and calcineurin inhibitors. While the exact mechanism of action of ECP is not well-understood, evidence suggests that reinfusion of the patient's apoptotic white blood cells, the ultimate product of ECP, promotes immunomodulatory events that are beneficial in patients with CTCL, transplant rejection, GVHD, and possibly other inflammatory conditions.
Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama.
Marisa B
MB
Marques
Jill
J
Adamski
D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D017209:Apoptosis; D001327:Autoimmune Diseases / Q000628:therapy; D003131:Combined Modality Therapy; D003713:Dendritic Cells / Q000276:immunology; D006084:Graft Rejection / Q000188:drug therapy / Q000628:therapy; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000628:therapy; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007108:Immune Tolerance; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007249:Inflammation; D007962:Leukocytes / Q000166:cytology / Q000276:immunology; D016410:Lymphoma, T-Cell, Cutaneous / Q000628:therapy; D017893:Photopheresis / Q000295:instrumentation / Q000379:methods* / Q000639:trends
D000925:Anticoagulants; D007166:Immunosuppressive Agents; D006493:Heparin
cutaneous T cell lymphoma; extracorporeal photopheresis; graft-versus-host disease; transplant rejection