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Role of extracorporeal photopheresis in the management of acute and chronic graft versus disease: current status

Bone Marrow Transplantation (2024)Cite this article

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Abstract

Extracorporeal photopheresis (ECP) is a therapy that combines the collection of mononuclear cells by apheresis, the addition of a photosensitizer (8-methoxisoralen), the illumination of the product with ultraviolet A light, and the immediate infusion of the product to the patient. Initially developed and approved to treat T-cell cutaneous lymphomas, soon started to be used to treat graft versus host disease (GvHD) developed after allogeneic hematopoietic-cell transplantation. The high response rate of ECP in skin, ocular, oral, pulmonary, and liver forms of chronic GvHD, the steroid-sparing effect, and the improved overall survival of treated patients, made ECP one of the second-line treatments used to treat steroid-resistant acute and chronic GVHD. Recently, the development of new drugs for treating GVHD has changed the position of ECP in the therapy of GVHD and has started to be used in combination with drugs for increasing the response rate to the treatment in severe or resistant forms of acute and chronic GVHD. ECP remains an essential therapeutic resource in the management of patients with refractory acute and chronic GVHD.

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Authors and Affiliations

  1. Apheresis and Cellular Therapy Unit, Hemotherapy and Hemostasis Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari, Barcelona, Spain

    Miquel Lozano, Paola Charry, Mar de Pablo-Miró & Joan Cid

  2. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

    Miquel Lozano, María-Queralt Salas, Carmen Martínez, María Suárez-Lledó, Francesc Fernández-Avilés, Montserrat Rovira & Joan Cid

  3. University of Barcelona, Barcelona, Spain

    Miquel Lozano, Carmen Martínez, Francesc Fernández-Avilés, Montserrat Rovira & Joan Cid

  4. Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari, Barcelona, Spain

    María-Queralt Salas, Carmen Martínez, María Suárez-Lledó, Francesc Fernández-Avilés & Montserrat Rovira

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ML, PC, MPM and CM wrote the manuscript. MQS, MSL, FAA, MR, and JC revised the manuscript. All authors have read and approved the final version of the manuscript and are accountable for all aspects of the work.

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Correspondence to Miquel Lozano.

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ML on behalf of his institution, Clinic Research Foundation, has received research support from Terumo BCT, Fresenius-Kabi, Macopharma, and Sanofi-Genzyme as a consultant ML has received fees from Macopharma. The other authors declare no competing financial interests.

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Lozano, M., Charry, P., de Pablo-Miró, M. et al. Role of extracorporeal photopheresis in the management of acute and chronic graft versus disease: current status. Bone Marrow Transplant (2024). https://doi.org/10.1038/s41409-024-02360-w

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