Extracorporeal Photopheresis for Chronic Graft-Versus-Host Disease

By Patrick Daly - Last Updated: July 14, 2022

In a recent analysis, investigators evaluated the use of extracorporeal photopheresis (ECP) for the treatment of chronic graft-versus-host disease (cGVHD) in patients who received an allogeneic hematopoietic stem cell transplant (allo-HSCT). Based on their results, the study’s lead author, Emin Kansu, and colleagues judged that “ECP remains an important therapeutic modality as a second-line therapy of cGVHD, and it was shown to be more effective with better response rates with longer therapy periods.”

The study, published in Hematology, reviewed 59 retrospective patients with cGVHD who were treated with ECP at a single center. According to the authors, the best organ responses to ECP were seen in the skin, mouth mucosa, eyes, and liver. The overall response rate (ORR) of the patients was 81.2%, of which 17% were complete responses and 64.2% were partial responses. The one- and three-year overall survival (OS) rates of the group were 84.9% and 36.7%, respectively.

Notably, the researchers found that patients who had responded to ECP maintained their responses with continuation of ECP, with a higher response rate in patients treated for 12 or more months. Additionally, the authors reported that female sex appeared to be advantaged in ORR. Generally, the authors proposed that patients who respond to ECP should receive an extended therapy schedule.

Overall, the authors highlighted the value of ECP in avoiding the problems associated with typical immunosuppressive therapies for cGVHD. In closing, they described ECP as safe and well-tolerated and specified that “ECP for a period of 24 weeks or longer did not result in any detectable complications and it offered the advantage of tapering or discontinuation of corticosteroids in patients with cGVHD.”