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Extracorporeal photopheresis

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https://www.readbyqxmd.com/read/29664769/european-reflections-on-new-indications-for-extracorporeal-photopheresis-in-solid-organ-transplantation
#1
Norbert Ahrens, Edward K Geissler, Volker Witt, Marc Berneburg, Daniel Wolff, Stephan W Hirt, Bernhard Banas, Hans J Schlitt, James A Hutchinson
No abstract text is available yet for this article.
April 17, 2018: Transplantation
https://www.readbyqxmd.com/read/29589657/-extracorporeal-photopheresis
#2
Aurélie Hsieh, Begonia Cortés
During the treatment of extracorporeal photopheresis (ECP), white blood cells are collected by apheresis and exposed to ultraviolet A after incubation with 8-methoxypsoralen. Although ECP was first developed for cutaneous T cell lymphoma, it has shown promising efficacy in a number of other serious conditions, like acute and chronic graft-versus-host disease, lung and cardiac transplant rejection and other autoimmune diseases. The ECP has been used for thirty years in some specialized centers but remains unknown to most of the physicians...
March 28, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29557913/extracorporeal-photopheresis-for-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#3
Ramsey Hachem, Paul Corris
BACKGROUND: Lung transplantation is a therapeutic option for select patients with end-stage lung disease. However, successful lung transplantation is hampered by chronic lung allograft dysfunction (CLAD), in particular bronchiolitis obliterans syndrome (BOS). Although there is no approved or standard treatment for BOS, which may have several distinct phenotypes, extracorporeal photopheresis (ECP) has shown promising results in patients who develop BOS refractory to azithromycin treatment...
March 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29550629/steroid-refractory-chronic-graft-versus-host-disease-cost-effectiveness-analysis
#4
Fevzi F Yalniz, Mohammad H Murad, Stephanie J Lee, Steven Z Pavletic, Nandita Khera, Nilay D Shah, Shahrukh K Hashmi
Given the increasing incidence of cGVHD and its rapidly escalating costs due to many lines of drug treatments, we aimed to perform a meta-analysis to assess the comparative effectiveness of various treatment options. Using these results, we then conducted a cost effectiveness analysis (CEA) for the frequently utilized agents in SR-cGVHD. We searched for studies examining tacrolimus, sirolimus, rituximab, ruxolitinib, hydroxychloroquine, imatinib, bortezomib, ibrutinib, extracorporeal photopheresis (ECP), pomalidomide and methotrexate...
March 14, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29544653/-buschke-s-scleredema-successfully-treated-with-extracorporeal-photopheresis
#5
F Dezoteux, M Bourges, A Lionet, O Carpentier
BACKGROUND: Scleredema adultorum (Buschke's scleredema) is a cutaneous mucinosis of unknown origin, clinically characterized by a diffuse induration of the skin usually involving the neck, shoulders and back, which limits patients' mobility. CASE REPORT: We report a case of a 50-year-old woman who presented a chronic sclerodermiform syndrome for 2 years associated with type 1 diabetes. Physical examination revealed an extensive skin induration involving the shoulders, neck and back...
March 12, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29477942/reflections-on-the-usefulness-of-extracorporeal-photopheresis-in-renal-transplant-rejection-a-concise-review-of-the-involved-mechanisms-and-therapeutic-perspectives
#6
REVIEW
Claudia Del Fante, Jerard Seghatchian, Cesare Perotti
Renal rejection clinically represents a major cause of graft dysfunction and sadly the loss of the renal transplant. This is despite the considerable progress in immunosuppressive therapy. It is strongly believed that the complex immunologic network underlying the response against major histocompatibility molecules (MHC) is responsible for rejection, an unresolved issue that is, in part, not inhibited by the current prophylactic and therapeutic strategies. Extracorporeal photopheresis (ECP) is an effective cell therapy approach that was successfully used in immunomodulating heart rejection, acute and chronic GvHD, lung rejection and some selected autoimmune diseases...
February 21, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29460964/comparison-between-8-methoxypsoralen-and-5-aminolevulinic-acid-in-killing-t-cells-of-photopheresis-patients-ex-vivo
#7
Toril Holien, Odrun Arna Gederaas, Sagar Ramesh Darvekar, Eidi Christensen, Qian Peng
BACKGROUND AND OBJECTIVE: Extracorporeal photopheresis (ECP), an established modality for cutaneous T-cell lymphoma (CTCL) and graft-versus-host disease, involves ex vivo treatment of isolated leukocytes of a patient with the photosensitizing drug 8-methoxypsoralen (8-MOP) and ultraviolet-A (UV-A) exposure before reinfusion back to the patient. However, 8-MOP binds to both diseased and normal cells and thus kills both types of the cells after UV-A illumination with little selectivity...
February 20, 2018: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/29451308/apheresis-buffy-coat-collection-without-photoactivation-has-no-effect-on-apoptosis-cell-proliferation-and-total-viability-of-mononuclear-cells-collected-using-photopheresis-systems
#8
Zbigniew M Szczepiorkowski, Christine A Burnett, Larry J Dumont, Sunil H Abhyankar
BACKGROUND: Extracorporeal photopheresis (ECP) has been approved for the treatment of advanced cutaneous T-cell lymphoma since 1988. While the precise mechanisms resulting in clinical effects are not fully understood, the photoactivation of mononuclear cells (MNCs) using ultraviolet A (UVA) light and methoxsalen is believed to be the predominant initiating process. The effects of MNC passage through the instrument without photoactivation are unknown. The objective of this study was to evaluate the effect of cell processing through the photopheresis instruments on MNCs...
February 16, 2018: Transfusion
https://www.readbyqxmd.com/read/29446444/extracorporeal-photopheresis-as-second-line-therapy-for-patients-with-acute-graft-versus-host-disease-does-the-number-of-cells-treated-matter
#9
Nina Worel, Elisabeth Lehner, Harald Führer, Peter Kalhs, Werner Rabitsch, Margit Mitterbauer, Georg Hopfinger, Hildegard T Greinix
BACKGROUND: Extracorporeal photopheresis (ECP) has demonstrated efficacy as second-line treatment for steroid-refractory (SR) acute graft-versus-host disease (aGVHD). The aim of our study was to analyze whether the amount of ECP-treated cells in patients with SR, aGVHD has an impact on response at 1 month. STUDY DESIGN AND METHODS: Data on white blood cells, lymphocytes, monocytes, mononuclear cells, and neutrophils, including absolute counts and counts per kilogram of body weight in ECP products from patients with aGVHD, were collected...
February 15, 2018: Transfusion
https://www.readbyqxmd.com/read/29443412/an-ex-vivo-comparison-of-vascular-access-devices-used-in-extracorporeal-photopheresis
#10
Jeffrey Szymanski, Priyank Shah, Marian Dynis, Donna Mansfield, Connie Hamilton, George Despotis
BACKGROUND: Central venous access devices are commonly used in extracorporeal photopheresis, but their performance has not been systematically evaluated. The primary objective of this study was to compare pressures at various flow rates for central venous access devices in an ex vivo simulation of photopheresis. STUDY DESIGN AND METHODS: Diluted, heparinized red blood cells were circulated through central access devices in series with a photopheresis system, and pressures at several flow rates were recorded...
February 2018: Transfusion
https://www.readbyqxmd.com/read/29443405/vascular-access-considerations-for-extracorporeal-photopheresis
#11
REVIEW
Jill Adamski
Extracorporeal photopheresis is an immunomodulatory therapy indicated for patients with cutaneous T-cell lymphoma, graft-versus-host disease, and heart or lung allograft rejection. Whole blood from the patient is drawn into the photopheresis instrument where it is separated into its components. Plasma, red blood cells, and the treated buffy coat are subsequently returned to the patient. Consistent, adequate blood flow is necessary to successfully complete the procedure. Vascular access options for photopheresis include peripheral vein cannulation, tunneled central venous catheters, and subcutaneous ports...
February 2018: Transfusion
https://www.readbyqxmd.com/read/29395846/thymopoiesis-following-hsct-a-retrospective-review-comparing-interventions-for-agvhd-in-a-pediatric-cohort
#12
A M Flinn, C F Roberts, M A Slatter, R Skinner, H Robson, J Lawrence, J Guest, A R Gennery
Acute graft-versus-host disease (aGVHD) complicates allogeneic hematopoietic stem cell transplantation (HSCT), and is treated with topical and/or systemic corticosteroids. Systemic corticosteroids and aGVHD damage thymic tissue. We compared thymopoietic effect of topical steroid therapy, corticosteroids and extracorporeal photopheresis (ECP) in 102 pediatric allogeneic HSCT patients. We categorized patients into 4 groups: - no aGVHD, aGVHD treated with topical or systemic steroid, or ECP. Naïve CD4+CD45RA+CD27+ T-lymphocyte values at 3, 6, 9, 12months post-HSCT were recorded: for ECP patients, values were recorded at 3, 6, 9, 12months during ECP...
January 27, 2018: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/29380491/extracorporeal-photopheresis-as-second-line-treatment-therapy-in-life-threatening-primary-graft-dysfunction-following-lung-transplantation
#13
Cécile A Robinson, Ilhan Inci, Mirjam Naegeli, Christian Murer, Macé M Schuurmans, Mirjana Urosevic-Maiwald, Reto Schüpbach, Walter Weder, Christian Benden
ECP is an established "second-line" treatment for CLAD/BOS. Recently, ECP was used for the first time in an adolescent CF patient as a "second-line" treatment therapy in life-threatening primary graft dysfunction following lung transplantation who deteriorated despite extensive treatment including ECMO and ATG. Within 10 days after initiation of ECP twice weekly, allograft function and clinical status improved significantly and the patient was weaned from mechanical ventilation support...
January 29, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29222315/extracorporeal-photopheresis-cellular-therapy-for-the-treatment-of-acute-and-chronic-graft-versus-host-disease
#14
REVIEW
Jennifer Schneiderman
Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative option for many disease states. Despite significant improvements in strategies used to prevent and treat acute and chronic graft-versus-host disease (a/cGVHD), they continue to negatively affect outcomes of HSCT significantly. Standard, first-line treatment consists of corticosteroids; beyond this, there is little consistency in therapeutic regimens. Current options include the addition of various immunosuppressive agents, the use of which puts patients at even higher risks for infection and other morbidities...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29214116/compassionate-use-of-ruxolitinib-in-acute-and-chronic-graft-versus-host-disease-refractory-both-to-corticosteroids-and-extracorporeal-photopheresis
#15
Mauricio Sarmiento Maldonado, Pablo Ramírez Villanueva, Pablo Bertín Cortes-Monroy, Veronica Jara Arias, Katherine Soto Donoso, Pablo Uribe Gonzalez, Mauricio Ocqueteau Tachini, Jose Antonio Perez-Simón
Background: Ruxolitinib is a potent inhibitor of JAK1/2 with proven efficacy in myelofibrosis. In recent years, research in graft versus host disease (GVHD) has revealed the role of activation of JAK pathways in alloreactive lymphocytes. Some reports have shown significant responses in refractory GVHD patients. Cases presentation: In this report we present our experience in 8 patients with acute or chronic GVHD with refractoriness to steroids and extracorporeal photopheresis treated with ruxolitinib...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/29193271/extracorporeal-photopheresis-for-graft-versus-host-disease-identifying-a-clinical-pathway-and-associated-resource-utilization
#16
Swaroopa Yerrabothala, Laleh Talebian, Karen Klinker, Joshua Hickman, John M Hill, Christi Hayes, Christopher Lowrey, Zbigniew M Szczepiorkowski, Kenneth R Meehan
Extracorporeal photopheresis (ECP) is an established therapy for the treatment of graft-versus-host-disease (GVHD) following an allogeneic stem cell transplant. We performed a prospective analysis of patients receiving ECP treatment for GVHD to identify a clinical pathway and resource utilization of this process. The cohort included consecutive allogeneic stem cell recipients with GVHD. ECP was performed using the CELLEX Photopheresis System or the UVAR XTS Photopheresis System (Therakos, Inc, Exton, PA). A clinical pathway was developed and a time and motion study was conducted to define the resource utilization and costs associated with ECP...
November 28, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29191068/an-exploratory-cost-effectiveness-analysis-of-systemic-treatments-for-cutaneous-t-cell-lymphoma
#17
Larisa Geskin, Daniel C Malone
PURPOSE: To conduct an exploratory cost-effectiveness analysis of systemic treatment options for more advanced cutaneous T-cell lymphoma (CTCL). METHODS: A cost-effectiveness model compared systemic bexarotene, denileukin diftitox, interferon-α, methotrexate, pralatrexate, romidepsin, vorinostat, and extracorporeal photopheresis (ECP) treatment of CTCL. Treatment effectiveness data were extracted from published studies and/or US product labeling. Overall response, the primary effectiveness measure, was defined as the proportion of patients achieving complete or partial response...
December 18, 2017: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/29139162/epidemiology-of-therapeutic-apheresis-with-a-multidisciplinary-approach-at-a-high-volume-pediatric-center
#18
Rachel M Sirignano, Matthew L Paden, Ross Fasano, Erin K Meyer
INTRODUCTION: Therapeutic apheresis (TA) is used inconsistently in pediatric populations. We seek to define our multidisciplinary institutional practice. METHODS: We conducted a retrospective chart review of patients receiving TA from January 1, 2012 through October 31, 2015. Data collected included demographics, American Society of Apheresis (ASFA) indication, complications, and mortality. RESULTS: Over 46 months, 1198 TA procedures were conducted on 289 patients ranging in age from 5 months to 21 years with weights ranging from 4...
November 15, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29134658/-best-practice-for-extracorporeal-photopheresis-in-acute-and-chronic-graft-versus-host-disease-by-societa-italiana-di-emaferesi-and-manipolazione-cellulare-and-gruppo-italiano-trapianto-midollo-osseo-a-national-survey-to-ascertain-its-degree-of-application
#19
Luca Pierelli, Alberto Bosi, Attilio Olivieri
BACKGROUND: A recent "best practice" promoted and published by Gruppo Italiano Trapianto Midollo Osseo (GITMO) and Societa' Italiana di Emaferesi and Manipolazione Cellulare (SIDEM) on the use of extracorporeal photopheresis (ECP) in acute and chronic graft-versus-host disease (GVHD) has been tested for the degree of agreement and application among Italian transplant centers. STUDY DESIGN AND METHODS: Twenty-four Italian centers coordinating a pair number of transplant programs completed the Web-based survey within the fixed deadline, representing approximately 52% of those centers that have a GITMO-accredited allogeneic transplant program that routinely uses ECP in GVHD...
January 2018: Transfusion
https://www.readbyqxmd.com/read/29124710/ultraviolet-irradiation-of-blood-the-cure-that-time-forgot
#20
Michael R Hamblin
Ultraviolet blood irradiation (UBI) was extensively used in the 1940s and 1950s to treat many diseases including septicemia, pneumonia, tuberculosis, arthritis, asthma and even poliomyelitis. The early studies were carried out by several physicians in USA and published in the American Journal of Surgery. However with the development of antibiotics, UBI use declined and it has now been called "the cure that time forgot". Later studies were mostly performed by Russian workers and in other Eastern countries and the modern view in Western countries is that UBI remains highly controversial...
2017: Advances in Experimental Medicine and Biology
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