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A Critical Appraisal of Extracorporeal Photopheresis as a Treatment Modality for Acute and Chronic Graft-Versus-Host Disease

1
Department of Internal Medicine, George Washington University School of Medicine, Washington, DC 20052, USA
2
Department of Blood & Marrow Transplantation and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
*
Author to whom correspondence should be addressed.
Biomedicines 2017, 5(4), 60; https://doi.org/10.3390/biomedicines5040060
Received: 28 August 2017 / Revised: 28 September 2017 / Accepted: 9 October 2017 / Published: 11 October 2017
(This article belongs to the Special Issue Cell Therapy for the Treatment of GVHD)
Although significant advances have been made in the biologic understanding of graft-versus-host disease (GVHD) and its treatment options, GVHD remains the single most challenging obstacle to the success of allogeneic hematopoietic cell transplantation (HCT) due to high risk of disabling morbidity and mortality. Extracorporeal photopheresis (ECP) has promising effects in controlling steroid-refractory GVHD, both acute and chronic, and it has been studied extensively. Its putative immunomodulatory mechanisms, while not immunosuppressive, position ECP as an attractive treatment strategy for GVHD patients who are already receiving global immunosuppression. However, ECP is relatively underutilized due in part to limited access and time commitment. Here, we review the recent findings on the ECP efficacy in both acute and chronic GVHD, primarily for steroid-refractory status, and we critically appraise its benefits. We also explore salient considerations on the optimal use of ECP in the treatment of refractory GVHD. View Full-Text
Keywords: extracorporeal photopheresis; steroid-refractory acute and chronic graft-versus-host disease extracorporeal photopheresis; steroid-refractory acute and chronic graft-versus-host disease
MDPI and ACS Style

Rafei, H.; Kharfan-Dabaja, M.A.; Nishihori, T. A Critical Appraisal of Extracorporeal Photopheresis as a Treatment Modality for Acute and Chronic Graft-Versus-Host Disease. Biomedicines 2017, 5, 60.

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