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J Clin Apher 2021 May 8. Epub 2021 May 8.

Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.

Background: This study assessed pharmacoeconomic costs associated with extracorporeal photopheresis (ECP) compared with other available second-line therapies for chronic graft-vs-host disease (cGvHD) in a tertiary Spanish institution.

Methods: Patients (≥18 years) diagnosed with steroid-refractory cGvHD were eligible. Data were collected retrospectively from index date until 1 year or relapse. Read More

Transfus Med 2021 May 5. Epub 2021 May 5.

Department of Pathology & Immunology, Division of Laboratory & Genomic Medicine, Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.

Background: This study was designed to prospectively evaluate the efficacy of extracorporeal photopheresis (ECP) to attenuate the rate of decline of FEV in lung transplant recipients with refractory bronchiolitis obliterans. Due to an observed higher than expected early mortality, a preliminary analysis was performed.

Study Design And Methods: Subjects from 10 lung transplant centres were assigned to ECP treatment or to observation based on spirometric criteria, with potential crossover for those under observation. Read More

J Dermatolog Treat 2021 May 4:1-12. Epub 2021 May 4.

Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.

Background: Extracorporeal photopheresis (ECP) has been considered for treatment of patients with systemic sclerosis (SSc).

Objectives: To study the 12-month effects of ECP on laboratory parameters and evaluate the SSc-related long-term survival.

Methods: 59 SSc patients who had received at least 6 ECP cycles were included. Read More

Clin Transplant 2021 Apr 29:e14333. Epub 2021 Apr 29.

Division of Cardiology, Columbia University.

Heart transplantation is the gold standard therapeutic option for select patients with end-stage heart failure. Unfortunately, successful long-term outcomes of heart transplantation can be hindered by immune-mediated rejection of the cardiac allograft, specifically acute cellular rejection, antibody-mediated rejection, and cardiac allograft vasculopathy. Extracorporeal photopheresis is a cellular immunotherapy that involves the collection and treatment of white blood cells contained in the buffy coat with a photoactive psoralen compound, 8-methoxy psoralen, and subsequent irradiation with ultraviolet A light. Read More

J Cancer Surviv 2021 Apr 4. Epub 2021 Apr 4.

Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia.

Background: Allogenic blood and marrow transplant (allo-BMT) is an arduous treatment used increasingly for many life-threatening conditions. Recognition of the profound impacts of the long term and late effects is ever-growing, as is the healthcare workload (treatment burden) of survivorship.

Purpose: To quantify the treatment burden of long-term survival following allo-BMT, regarding the range of health services, therapies and investigations accessed by survivors. Read More

Exp Hematol Oncol 2021 Mar 17;10(1):22. Epub 2021 Mar 17.

Servizio Di Immunoematologia E Medicina Trasfusionale, ASST Grande Ospedale Metropolitano Niguarda, Piazza Dell'Ospedale Maggiore, 3, 20162, Milano, Italy.

Transfus Med 2021 Apr 4;31(2):113-120. Epub 2021 Mar 4.

Institute for Clinical Chemistry and Laboratory Medicine, Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany.

Objectives: This validation study investigated a flow cytometric apoptosis assay according to good manufacturing practice (GMP).

Background: Extracorporeal photopheresis (ECP) is a treatment for various immunological diseases and cutaneous T-cell lymphomas. It is based on the induction of apoptosis by 8-methoxypsoralene and ultraviolet A light. Read More

J Clin Immunol 2021 Mar 2. Epub 2021 Mar 2.

Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.

Acute graft-versus-host disease (aGVHD) is a significant complication of allogeneic hematopoietic stem cell transplant (HSCT) and negatively affects T cell reconstitution. Extracorporeal photopheresis (ECP) reduces aGVHD, but the mechanisms remain incompletely understood. Our objective was to examine the impact of ECP on thymopoiesis in pediatric aGVHD and the mechanisms at a cellular and transcriptional level. Read More

Oncoimmunology 2021 Jan 31;10(1):1873530. Epub 2021 Jan 31.

Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Sézary syndrome (SS) is a rare, leukemic type of cutaneous T-cell lymphoma (CTCL), for which extracorporeal photopheresis (ECP) is a first-line therapy. Reliable biomarkers to objectively monitor the response to ECP in patients with SS are missing. We examined the quantitative and qualitative impact of ECP on natural killer (NK) cell activity in SS patients, and especially their functional ability for antibody-dependent cell-mediated cytotoxicity (ADCC). Read More

Actas Dermosifiliogr 2021 Feb 20. Epub 2021 Feb 20.

Sección de Fotoféresis, Fototerapia y Linfomas Cutáneos, Servicio de Dermatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address:

Background: Extracorporeal photopheresis (ECP) is an immunomodulatory therapy used to treat graft-vs-host disease (GVHD) in adults and children. Few studies have examined its use in children.

Objective: To describe demographic characteristics, clinical response, adverse effects, and outcomes in a series of pediatric patients with acute or chronic GVHD treated with ECP. Read More

JAAD Case Rep 2021 Mar 12;9:24-27. Epub 2021 Jan 12.

Mayo Clinic Arizona, Dermatology, Scottsdale, Arizona.

Exp Hematol Oncol 2021 Feb 16;10(1):14. Epub 2021 Feb 16.

Ematologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy.

The aim of the present study was to evaluate the circulating T regulatory cells (Tregs) in patients undergoing extracorporeal photopheresis (ECP) for the prevention of chronic graft-versus-host disease (GvHD) and to search for any correlation between Tregs counts and chronic GvHD occurrence. Among n = 12 patients with complete longitudinal data, the median cumulative values of absolute peripheral Tregs counts were 21.64 and 63. Read More

Expert Rev Anticancer Ther 2021 Feb 7. Epub 2021 Feb 7.

Hematology and Stem Cell Transplantation, Yale University School of Medicine, New Haven CT 06510, United States.

Introduction: The most common types of CTCL are mycosis fungoides (MF) and Sézary syndrome (SS). In both MF and SS, complete responses to treatment are uncommon. Recent developments and understanding of the biology of MF/SS has led to novel agents which may offer prolonged responses with less toxicity compared to conventional chemotherapy approaches. Read More

Case Rep Transplant 2021 22;2021:8831125. Epub 2021 Jan 22.

Haematology Unit, Department of Internal Medicine, Hospital Pulau Pinang, Jalan Residensi, 10990 Georgetown, Penang, Malaysia.

A middle-aged gentleman who was diagnosed with high-risk chronic lymphocytic leukaemia (CLL), Rai stage IV, Binet C with del(17p) and del(13q) underwent allogeneic haematopoeitic stem cell transplantation (allo-HSCT) from a human leukocyte antigen (HLA) identical sister. The patient developed extensive skin, oral, and liver chronic graft versus host disease (GVHD) required tacrolimus, mycophenolate mofetil (MMF), and prednisolone. At seventh month after allo-HSCT, the patient presented with systemic symptoms, right cervical lymphadenopathy, splenomegaly, marked pancytopaenia, and elevated lactate dehydrogenase (LDH). Read More

Immunotherapy 2021 Apr 28;13(5):387-395. Epub 2021 Jan 28.

Pharmerit, An OPEN Health Company, Bethesda, MD 20814, USA.

To compare secondary systemic treatment (SST) continuation and associated resource use and costs in chronic graft-versus-host disease (cGvHD) patients in the USA. : This was a retrospective study using Truven Health MarketScan database (2009-2016). cGvHD patients were classified as continuers or discontinuers if treated with SST for ≥180 days without or with a treatment gap (≥45 days), respectively. Read More

J Clin Apher 2021 Jan 21. Epub 2021 Jan 21.

Stem Cell Mobilization and Collection Unit, Istituto Europeo di Oncologia IRCCS, Milan, Italy.

Background: Stem Cell Mobilization and Collection Unit at Istituto Europeo di Oncologia (IEO; Milan, Lombardia) provides extracorporeal photopheresis (ECP) therapy to treat graft-vs-host disease (GvHD) using offline procedures. ECP can be administered via an integrated single device (online procedure). Total cost of performing ECP at IEO vs an integrated device was assessed using a micro-costing approach. Read More

Transplant Cell Ther 2021 Mar 14;27(3):278. Epub 2021 Jan 14.

The Department of Oncology, Vanderbilt University Medical Center, Tennessee Valley Veterans Affairs Hospital, Nashville, Tennessee.

Bone Marrow Transplant 2021 Jan 4. Epub 2021 Jan 4.

Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas Cancer Center, Houston, TX, USA.

Steroids remain the initial therapy for acute graft-vs.-host disease (AGVHD). Strategies to improve response and minimize steroid exposure are needed. Read More

J Am Acad Dermatol 2021 Mar 22;84(3):597-604. Epub 2020 Dec 22.

Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address:

In the past few decades, immunotherapy has emerged as an effective therapeutic option for patients with cutaneous T cell lymphoma (CTCL). CTCL is characterized by progressive impairment of multiple arms of the immune system. Immunotherapy targets these deficits to stimulate a more robust antitumor response, thereby both clearing the malignant T cells and repairing the immune dysfunction. Read More

Ther Adv Hematol 2020 8;11:2040620720977039. Epub 2020 Dec 8.

Health Economics and Evidence Synthesis Department, Synergus AB, Kevinge Strand 20, Danderyd, Stockholm 182 57, Sweden.

Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with an increased risk of graft--host disease (GvHD), a strong prognostic predictor of early mortality within the first 2 years following allo-HSCT. The objective of this study was to describe the harm outcomes reported among patients receiving second- and third-line treatment as part of the management for GvHD a systematic literature review.

Methods: A total of 34 studies met the systematic review inclusion criteria, reporting adverse events (AEs) across 12 different second- and third-line therapies. Read More

Dermatol Online J 2020 Nov 15;26(11). Epub 2020 Nov 15.

Department of Dermatology, CHU Amiens-Picardie, Amiens.

A 65-year-old man with acute myeloid leukemia 6 was treated by bone marrow allograft, developed a systemic classic chronic graft versus host disease with hepatic, rheumatologic, ophthalmic, and muco-cutaneous involvement. He received systemic corticosteroid, ruxolitinib and extracorporeal photopheresis which resulted in complete remission. During follow-up the patient presented with viral cutaneous warts on his neck and submandibular area. Read More

Transfusion 2021 Mar 10;61(3):883-893. Epub 2020 Dec 10.

Department of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.

Background: Extracorporeal photopheresis (ECP) is one of the most widely used and effective cell-based therapies for the treatment of T-cell-mediated diseases. The patients' white blood cells (WBCs) are collected by apheresis and exposed to the photosensitizer 8-methoxypsoralen (8-MOP) and ultraviolet A (UVA) light before retransfusion. The UVA/8-MOP combination has been in use in ECP for more than 4 decades; however, whether ECP can be simplified by UVA light irradiation only has never been analyzed. Read More

Eur J Health Econ 2021 Feb 4;22(1):169-180. Epub 2020 Dec 4.

Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.

Chronic graft versus host disease (cGVHD) is a debilitating and costly complication following haemopoietic stem cell transplantation (HSCT). This study describes the economic burden associated with cGVHD. Direct costs associated with specialised healthcare utilisation (inpatient admissions and outpatient visits), as well as indirect costs associated with sickness absence-associated productivity loss were estimated in patients who underwent allogeneic HSCT in Sweden between 2006 and 2015, linking population-based health and economic registers. Read More

J Cancer Res Clin Oncol 2021 Jun 21;147(6):1757-1761. Epub 2020 Nov 21.

Department of Radiation Oncology, University Hospital of Muenster, Building A1, 1 Albert Schweitzer Campus, 48149, Muenster, Germany.

Purpose: Low-dose total skin electron beam therapy (TSEBT) over 3 weeks has proved to be a safe and effective treatment for cutaneous T cell lymphomas (CTCL). In this prospective trial, we examined the feasibility of ultra-hypofractionated low-dose TSEBT regimen in two fractions with 4 Gy combined with systemic therapy to minimize the number of visits to radiation centers.

Patients And Methods: Six patients with mycosis fungoides (MF) or Sézary syndrome (SS) received TSEBT with a total radiation dose of 8 Gy in two fractions between April 2020 and June 2020. Read More

Bone Marrow Transplant 2021 Apr 20;56(4):980-982. Epub 2020 Nov 20.

Division of Hematological Malignancies and Cellular Therapy, University of Kansas Medical Center, Kansas City, KS, USA.

Bone Marrow Transplant 2021 Apr 17;56(4):909-916. Epub 2020 Nov 17.

Department of Medicine I, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany.

Glucocorticoid-refractory (SR) chronic (c) graft-versus-host disease (GVHD) is a multisystem immunological disease and the leading cause of non-relapse mortality (NRM) in patients surviving longer than 2 years after allogeneic hematopoietic cell transplantation. Both ruxolitinib (RUX) and extracorporeal photopheresis (ECP) have shown activity for SR-cGVHD which motivated us to treat refractory cGHVD patients with the RUX-ECP combination. In this retrospective survey, 23 patients received RUX-ECP as salvage therapy for SR-cGVHD. Read More

JAMA Dermatol 2021 01;157(1):90-95

Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Importance: Sézary syndrome (SS) is an advanced form of cutaneous T-cell lymphoma with few long-term remissions observed.

Objective: To profile 3 patients with SS who have experienced long-term remission following the addition of low-dose total skin electron beam therapy (TSEBT) to systemic regimens of extracorporeal photopheresis, bexarotene, and interferon-γ.

Design, Setting, And Participants: This is a retrospective case series with additional investigations of patient-donated samples to assess therapeutic response. Read More

Ital J Dermatol Venerol 2021 Feb 21;156(1):73-83. Epub 2020 Oct 21.

Unit of Dermatology, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy -

Background: Sézary Syndrome (SS) is a rare and aggressive variant of cutaneous T-cell lymphoma characterized by erythroderma, generalized lymphadenopathy and atypical lymphocytes in peripheral blood. The aim of the study is to describe our experience with SS patients.

Methods: Nine SS patients were retrospectively identified within 288 patients with cutaneous T-cell lymphomas (CTCLs) followed from 1977 to 2017 in the Unit of Dermatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. Read More

Clin Exp Immunol 2021 Feb 8;203(2):329-339. Epub 2020 Nov 8.

Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University, Giessen, Germany.

Extracorporeal photopheresis (ECP) represents one of the most widespread and effective cell therapies for graft-versus-host disease and other T cell-mediated disorders. However, the key factors affecting the therapeutic efficacy of ECP remain unclear. We hypothesized that therapeutic effects are mediated by ECP-treated antigen-presenting dendritic cells (DC). Read More