In medicine, photopheresis (aka extracorporeal photopheresis or ECP) is a form of a pheresis and photodynamic therapy in which blood is treated with a photosensitizing agent and subsequently irradiated with specified wavelengths of light to achieve an effect. Specifically, buffy coat (WBC + platelets) is separated from whole blood, chemically treated with 8-methoxypsoralen(instilled into collection bag or given per os in advance), exposed to ultraviolet light (UVA), and returned to the patient.Activated 8-methoxypsoralen crosslinks DNA in exposed cells, ultimately resulting apoptosis of nucleated cells.
Photopheresis involving 8-methoxypsoralen was first described in a 1987 New England Journal of Medicine publication. Photopheresis is currently standard of care therapy approved by the U.S. Food and Drug Administration (FDA) for cutaneous T-cell lymphoma. Evidence suggests that this treatment might be effective in the treatment of graft-versus-host disease, though this evidence is largely observational and controlled trials are needed to support this use. Photopheresis has also been used successfully in the treatment of epidermolysis bullosa acquisita when all other treatments have been ineffective.
Minimal observed side effects for patients receiving photopheresis include hypotension and syncope resulting from volume shifts during leukapheresis phase of treatment. Photopheresis is also used as an experimental treatment in patients with cardiac, pulmonary and renal allograft rejection, graft-versus-host disease, autoimmune diseases, nephrogenic systemic fibrosis and ulcerative colitis.
Extracorporeal Photopheresis with the Autologous Dendritic Cell Cancer Vaccine
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- “National Coverage Determination (NCD) for Extracorporeal Photopheresis (110.4)”. Medicare Coverage Database. Centers for Medicare and Medicaid Services. 30 April 2012. Item/Service Description. 100-3.
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- Weitz, Marcus; Strahm, Brigitte; Meerpohl, Joerg J.; Schmidt, Maria; Bassler, Dirk (2015-12-15). “Extracorporeal photopheresis versus alternative treatment for chronic graft-versus-host disease after haematopoietic stem cell transplantation in paediatric patients”. The Cochrane Database of Systematic Reviews (12): CD009898. doi:10.1002/14651858.CD009898.pub3. ISSN 1469-493X. PMID 26666581.
- Weitz, Marcus; Strahm, Brigitte; Meerpohl, Joerg J.; Schmidt, Maria; Bassler, Dirk (2015-12-15). “Extracorporeal photopheresis versus standard treatment for acute graft-versus-host disease after haematopoietic stem cell transplantation in paediatric patients”. The Cochrane Database of Systematic Reviews (12): CD009759. doi:10.1002/14651858.CD009759.pub3. ISSN 1469-493X. PMID 26666580.
- Gupta, R; Woodley, D. T.; Chen, M (2012). “Epidermolysis bullosa acquisita”. Clinics in Dermatology. 30 (1): 60–9. doi:10.1016/j.clindermatol.2011.03.011. PMC 3234994. PMID 22137228.
Extracorporeal photopheresis entry in the public domain NCI Dictionary of Cancer Terms
Extracorporeal photopheresis definition at eMedicine.com
Extracorporeal photopheresis discussion at Stanford School of Medicine