title: Extracorporeal photopheresis practice patterns: An international survey by the ASFA ECP subcommittee.
abstract: BACKGROUND
  Although many apheresis centers offer extracorporeal photopheresis (ECP), little is known about current treatment practices.
  
  
  METHODS
  An electronic survey was distributed to assess ECP practice internationally.
  
  
  RESULTS
  Of 251 responses, 137 met criteria for analysis. Most respondents were from North America (80%). Nurses perform ECP at most centers (84%) and the majority of centers treat adults only (52%). Most centers treat fewer than 50 patients/year (83%) and perform fewer than 300 procedures/year (70%). Closed system devices (XTS and/or Cellex) are used to perform ECP at most centers (96%). The most common indications for ECP are acute/chronic skin graft versus host disease (89%) and cutaneous T-cell lymphoma (63%). The typical wait time for ECP treatment is less than 2 weeks (91%). Most centers do not routinely perform quality control assessment of the collected product (66%). There are device-specific differences in treatment parameters. For example, XTS users more frequently have a minimum weight limit (P = 0.003) and use laboratory parameters to determine eligibility for treatment (P = 0.03). Regardless of device used, the majority of centers assess the clinical status of the patient before each procedure. Greater than 50% of respondents would defer treatment for hemodynamic instability due to active sepsis or heart failure, positive blood culture in the past 24 h or current fever.
  
  
  CONCLUSIONS
  This survey based study describes current ECP practices. Further research to provide evidence for optimal standardization of patient qualifications, procedure parameters and product quality assessment is recommended.
authors.affiliation: Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Dunbar
authors.affiliation: Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Raval
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.
authors.forename: Andrew
authors.initials: A
authors.lastname: Johnson
authors.affiliation: Department of Pediatrics, New York Medical College, Valhalla, NY.
authors.forename: Cori M
authors.initials: CM
authors.lastname: Abikoff
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ.
authors.forename: Jill
authors.initials: J
authors.lastname: Adamski
authors.affiliation: Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Cooling
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors.forename: Brenda
authors.initials: B
authors.lastname: Grossman
authors.affiliation: Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Haewon C
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Department of Pathology, University of Alabama, Birmingham, AL.
authors.forename: Marisa B
authors.initials: MB
authors.lastname: Marques
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.|American Red Cross, St. Paul, MN.|Veterans Affairs Medical Center, Minneapolis, MN.
authors.forename: Shanna
authors.initials: S
authors.lastname: Morgan
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Schmidt
authors.affiliation: Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Sloan
authors.affiliation: Department of Pathology and Laboratory Medicine, Phoenix Children's Hospital, Phoenix, AZ.
authors.forename: Leon L
authors.initials: LL
authors.lastname: Su
authors.affiliation: Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH.|Institute of Hematology and Transfusion Medicine, Warsaw, Poland.
authors.forename: Zbigniew M
authors.initials: ZM
authors.lastname: Szczepiorkowski
authors.affiliation: Department of Pediatrics, New York Medical College, Valhalla, NY.
authors.forename: F Bernadette
authors.initials: FB
authors.lastname: West
authors.affiliation: Departments of Pediatrics and Pathology, George Washington School of Medicine and Health Sciences, Division of Laboratory Medicine, Children's National Health System, Washington, DC.
authors.forename: Edward
authors.initials: E
authors.lastname: Wong
authors.affiliation: Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital, Chicago, IL.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schneiderman
mesh_terms: D006086:Graft vs Host Disease / Q000628:therapy; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000628:therapy; D018579:Patient Selection; D017893:Photopheresis / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D011785:Quality Assurance, Health Care; D016038:Skin Transplantation / Q000009:adverse effects; D011795:Surveys and Questionnaires
keywords: apheresis; extracorporeal photopheresis; therapeutic apheresis