Small-scale extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma: A report of 3 cases

An automated mini buffy coat preparation method for use in mini extracorporeal photopheresis treatment of graft‐vs‐host‐disease in a low body weight pediatric patient

“…The data from an animal model showed that as few as 0.2% of the body's blood volume irradiated are sufficient to achieve an immune response after photopheresis . Based on these data Schreiner et al calculated that EPC with MNCs from 50 mL peripheral blood of a patient with cutaneous T‐cell lymphoma should yield a clinical effect . They developed small scale photopheresis procedure, and concentrate MNCs by density gradient centrifugation with Lymphoprep (Nycomed, Oslo, Norway).…”

“…Mini‐ECP is an “off line” technique that has been developed for use in the treatment of small children and patients with apheresis contraindications. In mini‐ECP the whole blood is collected from the patients and various methods have been used for mononuclear cell (MNC) separation and buffy coat preparation . In this report we describe an alternative method for mini buffy coat preparation using the automated Sepax cell laboratory separator (Biosafe, Switzerland) for the “off line” technique ECP treatment of a low body weight child with graft‐vs‐host‐disease.…”

Extracorporeal Photochemotherapy as a Challenging Treatment for Cutaneous T-Cell Lymphoma, Acute and Chronic Graft-versus-Host Disease, Organ Rejection and T-Lymphocyte-Mediated Autoimmune Diseases

“…Both patients with mycosis fungoides showed a prompt response to the treatment [47]. This last paper opened several questions on the number of cells to be treated and the frequency of the treatment and whether apheresis technology could be circumvented, at least in selected patients.…”

“…In all quoted studies, ECP was performed using the on-line method during which about 5-10% of the total circulating T cells were collected and treated. In 2005 Schreiner et al [47] reported on 3 patients with endstage CTCL (2 mycosis fungoides) not eligible for ECP, in whom a so-called 'small-scale ECP' was performed. Briefly, they collected MNC from 50 ml of whole blood, and after density gradient centrifugation the cells were UVA-irradiated in presence of 8-MOP.…”

Shortened apheresis-based extra-corporeal photochemotherapy for acute refractory GVHD in children: a prospective study

“…10 However, the clinical efficacy of a small-scale ECP calls into question this dose effect in the setting of aGVHD: by reinfusion of about ten times fewer cells than with conventional ECP, the authors reported an intriguing efficacy. 5,11 Although the exact mechanism of action of ECP remains largely unclear, the hypothesis of T-cell vaccination 12 supports this relative absence of cell-dose effect.…”