Extracorporeal photochemotherapy (ECP) in treatment of patients with c-GVHD and CTCL

Abstract 

We evaluated the immunomodulatory and clinical effect of 279 extracorporeal photochemotherapy (ECP) procedures which were performed in six patients with chronic extensive GVHD and in two patients with CTCL (cutaneous T-cell lymphoma)/Mycosis fungoides. ECP was performed using the off line regimen. In five of six patients with c-GVHD the improvement of sclerodermatous skin changes, joint mobility, and the reduction of joint pain was observed. Two patients with CTCL responded to ECP with rapid improvement of the skin changes. In patients with c-GVHD and CTCL who responded to ECP efficiently, we found the similar tendency to increase in the number of CD 3/8+ T-lymphocytes and the decrease of CD 4/8 IRI. In patients with CTCL we observed also the decrease in levels of CD 3/4+ T-lymphocytes and in the number of leukocytes. The influence of ECP on T-cell subsets and on the dendritic cells function, which we observed in our previous study, leads to the suggestion that interactions between T-cell subsets and dendritic cells may participate in the process of ECP. ECP did not cause any significant changes in levels of IgG, parameters of liver and renal functions in patients with c-GVHD and with CTCL. No increased incidence of infections and no serious adverse reactions in patients have been observed so far.

Keywords: Chronic GVHD, CTCL/Mycosis fungoides, Hematopoietic stem cell transplantation, Allogeneic transplantation, Extracorporeal photochemotherapy, ECP, Photopheresis