The role of extracorporeal photopheresis in the management of cutaneous T‐cell lymphoma, graft‐versus‐host disease and organ transplant rejection: a consensus statement update from the UK Photopheresis Society

Abstract

SummaryExtracorporeal photopheresis (ECP) has been used for over 35 years in the treatment of erythrodermic cutaneous T‐cell lymphoma (CTCL) and over 20 years for chronic and acute graft‐versus‐host disease (GvHD) and solid organ transplant rejection. ECP for CTCL and GvHD is available at specialised centres across the UK. The lack of prospective randomised trials in ECP led to the development of UK Consensus Statements for patient selection, treatment schedules, monitoring protocols and patient assessment criteria for ECP. The recent literature has been reviewed and considered when writing this update. Most notably, the national transition from the UVAR XTS ® machine to the new CELLEX machine for ECP with dual access and a shorter treatment time has led to relevant changes in these schedules. This consensus statement updates the previous statement from 2007 on the treatment of CTCL and GvHD with ECP using evidence based medicine and best medical practise and includes guidelines for both children and adults.

Favorable impact of extracorporeal photopheresis in acute and chronic graft versus host disease: Prospective single‐center study

“…In contrast to aGVHD, there is a larger experience with ECP in cGVHD . In total, ECP has been studied so far in 770 patients . Our cohort is one of the largest with a long‐term follow‐up.…”

Extracorporeal Photopheresis: An Efficacious and Well-Tolerated Treatment for Cutaneous and Oral Mucosal Chronic Graft-versus-Host Disease

“…Thus, we set a treatment schedule based on the clinical experience of expert dermatologists and hematologists who regularly treat cGVHD patients. When compared with the recently published consensus statement from the UK Photopheresis Society, we started reducing the treatment frequency later, and we waited 3 months after the last decrease/discontinuation of the immunosuppressive agents before starting to reduce the ECP treatment frequency [15]. …”

Successful treatment of sclerotic cutaneous graft‐versus‐host disease using extracorporeal photopheresis

“…The national European, British and American guidelines strongly support the use of ECP for the treatment of GVHD [2,[10][11][12][13]. Results of prospective trials of large cohorts have been published [14,15].…”