Clinical application of a low-volume extracorporeal photochemotherapy for the treatment of graft-versus-host disease

Introduction . Extracorporeal photopheresis (ECP) is an attractive method of treating graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation due to the lack of systemic immunosuppression. However, the clinical use of ECP is often limited by the need for leukapheresis. There are modifications of ECP without the use of leukapheresis, in particular low-volume ECP. Aim : to analyze the use of lv-ECP for the treatment of patients with acute and chronic GvHD. Patients and methods . The results of treatment of 9 cases of acute GVHD and 15 cases of chronic GVHD using the lv-ECP from April 2021 to March 2024 are presented. The cellular product was obtained by effusion of 15-30 ml of whole blood followed by photochemical treatment. The processed autologous cell product was administered to the patient. Results . The overall response in patients with acute GVHD was 44%, organ-specific response for skin lesions was 56 %, and for gastrointestinal lesions, 40%. In the treatment of chronic GvHD, the overall response was 73.3 %; the effectiveness of therapy for skin lesions was 71 %; for gastrointestinal lesions 67 %; for lung damage 67 %; for eye damage 100 %, for liver damage 100 %. Conclusion . lv-ECP has shown promising efficacy results in the treatment of acute and chronic GvHD. lv-ECP is an attractive alternative to standard ECP when leukapheresis is not possible.