Graft versus host disease is a frequent complication with high morbidity and mortality that develops after allogeneic hematopoietic stem cell transplantation due to donor T-lymphocytes attacking different tissues of the recipient. In allogeneic transplantation, cells from family members, unrelated donors or cord blood units are used. In GVHD, immune system cells from the graft derived from bone marrow, peripheral blood or cord blood attack the transplant patient's body. The effects of this attack can occur in different parts of the body. The skin, eyes, liver and gastrointestinal tract are often affected. GVHD can cause moderate to life-threatening damage to the recipient organism.

The therapeutic effects of ECP for GVHD include: induction of apoptosis in interfered lymphocytes, modulation of monocyte-derived dendritic cell (DC) differentiation, increased anti-inflammatory cytokine production in monocytes and T cells, decreased DC antigen-presenting function, restoration of normal helper T cells and DC subsets, and induction of regulatory T cells to provide immune tolerance.

Extracorporeal Fotoferez

Approximately 200-270 ml of mononuclear cell product consisting of mononuclear cells, MNCs obtained by the double TBV process in the two-process method are collected and processed.

Two consecutive days (one series), every 1 to 2 weeks

All photoactive leukocytes are reinfused: albumin, SF

In acute GVHD, each series of ECP is administered weekly until a response is achieved (usually within 4 weeks), then tapered and discontinued. In chronic GVHD, ECP treatment is administered weekly in batches until a response is obtained (or for a total of 8-12 weeks) and then tapered and discontinued after maximum response.