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Extracorporeal photopheresis

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https://www.readbyqxmd.com/read/28641548/pediatric-cutaneous-graft-versus-host-disease-a-review
#1
Vinod E Nambudiri, Connie R Shi, Jennifer T Huang
BACKGROUND: Graft versus host disease (GVHD) is a significant complication following hematopoietic stem cell transplantation in the pediatric population. The most common clinical manifestation of GVHD is in the skin. This article will present a review of key concepts related to pediatric cutaneous GVHD, including pathophysiology, clinical epidemiology, diagnosis, and treatment options. GVHD is an immune-mediated process characterized by an inflammatory immune response in acute GVHD and mixed inflammatory and fibrotic states in chronic GVHD...
June 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28608529/comparison-of-the-cellex%C3%A2-and-uvar-xts%C3%A2-closed-system-extracorporeal-photopheresis-devices-in-the-treatment-of-chronic-graft-versus-host-disease
#2
Robert M Whittle, Helen Denney, Andrew D Chantry, Arun Alfred, Peter C Taylor
Extracorporeal Photopheresis (ECP) is a cellular immunotherapy frequently used for steroid-refractory graft-versus-host disease (GVHD). Chronic GVHD (cGVHD), response to ECP is associated with survival benefit. The UVAR-XTS(TM) system and the more recently developed CELLEX(TM) device (both Therakos(TM) ) are the mainstay for ECP-delivery in the UK and US. No comparison of treatment outcomes has been reported. We retrospectively compared cGVHD response and steroid reduction and withdrawal in patients treated exclusively over 12 months with either the XTS (n = 51) or CELLEX (n = 50)...
June 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28587506/extracorporeal-photopheresis-for-gvhd-prophylaxis-after-reduced-intensity-conditioning-allogeneic-hematopoietic-stem-cell-transplantation-a-prospective-multicenter-phase-2-study
#3
Mauricette Michallet, Mohamad Sobh, Frederic Garban, Claude Eric Bulabois, Ibrahim Yakoub-Agha, Valerie Coiteux, Remy Dulery, Pierre-Simon Rohrlich, Faezeh Legrand, Laurence Clement, Aline Praire, Marie Detrait, Fiorenza Barraco, Franck Emmanuel Nicolini, Olivier Hequet
We performed a prospective multicenter phase 2 study to evaluate the safety and efficacy of prophylactic Extracorporeal Photopheresis (ECP) in adult patients with hematological malignancies early after RIC allo-HSCT on day 21 twice per week during the first two weeks and then once per week for the next four weeks for a total of eight ECP courses. A total of 20 patients were included; 10 were males, median age was 60 years. All patients engrafted, 17 (85%) received the total eight ECP courses. There were no adverse effects related to ECP...
June 7, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28578935/extracorporeal-photochemotherapy-in-mycosis-fungoides
#4
E Atilla, P A Atilla, S C Bozdag, M K Yuksel, S K Toprak, P Topcuoglu, B N Akay, H Sanli, H Akan, T Demirer, M Beksac, O Arslan, M Ozcan, G Gurman, O Ilhan
OBJECTIVES: Extracorporeal photo-chemotherapy (ECP, photopheresis) is an approved treatment modality for mycosis fungoides (MF). Our aim is to present our ECP data for MF. METHODS: We retrospectively evaluated 50 MF patients who received ECP for clinical activity, toxicity, and response and outcome rates, and we compared these with combination therapies. RESULTS: The overall response rate (ORR) was 42% (21/50), while the median time to response was 11months (range, 3-48months)...
May 31, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28512672/s%C3%A3-zary-syndrome-with-nodal-cd30-positive-manifestation-treated-with-brentuximab-vedotin-and-extracorporeal-photopheresis
#5
Valeria Behle, Tanja von Braunmühl, Cyrus Sayehli, Anja Gesierich, Matthias Goebeler, Eva Geissinger, Marion Wobser
No abstract text is available yet for this article.
May 17, 2017: Acta Dermato-venereologica
https://www.readbyqxmd.com/read/28488260/cessation-of-extracorporeal-photopheresis-in-chronic-lung-allograft-dysfunction-effects-on-clinical-outcome-in-adults
#6
Cécile A Robinson, Lars Huber, Christian Murer, Macé Schuurmans, Malcolm Kohler, Günther Hofbauer, Christian Benden
BACKGROUND: Extracorporeal photopheresis (ECP) has been reported to be safe and the ultimate treatment option in lung transplant recipients with chronic lung allograft dysfunction (CLAD), the main overall cause of mortality in lung transplant recipients. However, ECP is not reimbursed in selected health jurisdictions, and reimbursement by health insurance providers is a major issue. In Switzerland, ECP is not recognised by the health authorities as a therapy option for CLAD; thus by the end of 2014, ECP had to be stopped in the majority of adult lung transplant recipients cared for at the University Hospital Zurich because of lack of continuous funding...
May 10, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28466383/photopheresis-advances-and-use-in-systemic-sclerosis
#7
REVIEW
Xiaolong Alan Zhou, Jaehyuk Choi
PURPOSE OF REVIEW: Extracorporeal photochemotherapy (photopheresis, ECP) is a cell-based immunomodulatory treatment that separates leukocytes from peripheral blood, exposes them to a photosensitizing agent followed by ultraviolet A light, and then reinfuses them back into the patient. ECP has been found to be effective for graft versus host disease, transplant rejection, and various autoimmune diseases. The mechanism is not well understood but studies have shown clinical benefit in the treatment of systemic sclerosis (SSc)...
June 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28457374/efficacy-of-extracorporeal-photopheresis-in-patients-with-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#8
Y Pecoraro, C Carillo, D Diso, S Mantovani, G Cimino, T De Giacomo, P Troiani, M Shafii, L Gherzi, D Amore, E A Rendina, F Venuta, M Anile
BACKGROUND: Lung transplantation (LT) is only therapeutic option for patients affected by chronic respiratory failure. Chronic rejection, also known as bronchiolitis obliterans syndrome (BOS), is still the main cause of death and the most important factor that influences post-transplantation quality of life. Currently available therapies have not been proven to result in significant benefit in the prevention or treatment of BOS. Extracorporeal photopheresis (ECP) seems to reduce the rate of lung function decline in transplant recipients with progressive BOS...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28455878/impact-of-plerixafor-mozobil-on-hospital-efficiency-a-single-center-experience
#9
Nabih Azar, Maya Ouzegdouh, Sylvain Choquet, Véronique Leblond
Plerixafor (Mozobil) in combination with granulocyte colony-stimulating factor (G-CSF) has shown to increase mobilization of peripheral blood stem cells (PBSC) as compared to G-CSF alone in patients undergoing autologous stem cell transplantation (ASCT). However, up to 25% of patients treated with G-CSF alone still fail mobilization. Adding plerixafor to poor mobilizers allows to rescue these patients from mobilization failure and to reduce the number of apheresis sessions. The goal of this retrospective study was to capture the impact of plerixafor on treatment outcome and on apheresis department efficiency...
April 28, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28431983/comparison-of-extracorporeal-photopheresis-and-alemtuzumab-for-the-treatment-of-chronic-lung-allograft-dysfunction
#10
Anna Moniodis, Keri Townsend, Alexander Rabin, Obadah Aloum, Jessica Stempel, Patrick Burkett, Phillip Camp, Miguel Divo, Souheil El-Chemaly, Hari Mallidi, Ivan Rosas, Anne Fuhlbrigge, Sophia Koo, Hilary J Goldberg
BACKGROUND: Survival after lung transplantation is limited by chronic lung allograft dysfunction (CLAD). Immunomodulatory therapies such as extracorporeal photopheresis (ECP) and alemtuzumab (AL) have been described for refractory CLAD, but comparative outcomes are not well defined. METHODS: We retrospectively reviewed spirometric values and clinical outcomes after therapy with ECP, AL, or no treatment (NT) in patients with CLAD who underwent transplant between January 2005 and December 2014...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28419561/a-transition-from-using-multi-step-procedures-to-a-fully-integrated-system-for-performing-extracorporeal-photopheresis-a-comparison-of-costs-and-efficiencies
#11
Nabih Azar, Veronique Leblond, Maya Ouzegdouh, Paul Button
INTRODUCTION: The Pitié Salpêtrière Hospital Hemobiotherapy Department, Paris, France, has been providing extracorporeal photopheresis (ECP) since November 2011, and started using the Therakos(®) CELLEX(®) fully integrated system in 2012. This report summarizes our single-center experience of transitioning from the use of multi-step ECP procedures to the fully integrated ECP system, considering the capacity and cost implications. MATERIALS AND METHODS: The total number of ECP procedures performed 2011-2015 was derived from department records...
April 17, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28392150/factual-reflections-and-recommendations-on-extracorporeal-photopheresis-in-pediatrics
#12
REVIEW
Irena Sniecinski, Jerard Seghatchian
One of the biggest challenges in evaluating available literature on extracorporeal photopheresis (ECP) practices in pediatric patients is the marked heterogeneity of approaches to the patient evaluation, procedural aspects and apheresis product analysis. These issues are most relevant in ECP management in children with graft versus host disease (GVHD) after hematopoietic stem cell transplantation. Extracorporeal photopheresis in pediatric patients is considered relatively safe with few adverse effects reported from retrospective or observational studies...
March 22, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28386787/prospective-evaluation-of-systematic-use-of-peripherally-inserted-central-catheters-picc-lines-for-the-home-care-after-allogeneic-hematopoietic-stem-cells-transplantation
#13
J Cornillon, J A Martignoles, E Tavernier-Tardy, M Gire, P Martinez, C Tranchan, A Vallard, K Augeul-Meunier, B Hacquard, D Guyotat
PURPOSE: Long-term catheters are often necessary for outpatient care after an allogeneic hematopoietic stem cell transplantation (HSCT), However, there is paucity of data on the use of peripherally inserted central catheter (PICC) in post-HSCT setting. METHODS: We prospectively evaluated the systematic use of PICC in 37 consecutive patients returning home after HSCT. RESULTS: In 6 out of 37 patients, the PICC was exclusively used for weekly blood controls...
April 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28377936/novel-application-of-extracorporeal-photopheresis-as-treatment-of-graft-versus-host-disease-following-liver-transplantation
#14
Timothy J Brown, Cathy Gentry, Suntrea T G Hammer, Christine S Hwang, Madhuri Vusirikala, Prapti A Patel, Karén Matevosyan, Shannan R Tujios, Arjmand R Mufti, Robert H Collins
A 48-year-old man with hepatitis C virus (HCV) cirrhosis complicated by hepatocellular carcinoma underwent liver transplantation. His course was complicated by fever, diarrhea, abdominal pain, and pancytopenia. He developed a diffuse erythematous rash, which progressed to erythroderma. Biopsies of the colon and skin were consistent with acute graft-versus-host disease. Donor-derived lymphocytes were present in the peripheral blood. The patient was treated with corticosteroids and cyclosporine; however, he had minimal response to intensive immunosuppressive therapy...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28377772/treatment-of-pediatric-acute-graft-versus-host-disease-lessons-from-primary-immunodeficiency
#15
REVIEW
Aisling M Flinn, Andrew R Gennery
Allogeneic hematopoietic stem cell transplant (HSCT) is used to treat increasing numbers of malignant and non-malignant disorders. Despite significant advances in improved human leukocyte antigens-typing techniques, less toxic conditioning regimens and better supportive care, resulting in improved clinical outcomes, acute graft-versus-host disease (aGvHD) continues to be a major obstacle and, although it principally involves the skin, gastrointestinal tract, and liver, the thymus is also a primary target. An important aim following HSCT is to achieve complete and durable immunoreconstitution with a diverse T-cell receptor (TCR) repertoire to recognize a broad range of pathogens providing adequate long-term adaptive T-lymphocyte immunity, essential to reduce the risk of infection, disease relapse, and secondary malignancies...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28338261/extracorporeal-photopheresis-for-the-treatment-of-early-stage-mycosis-fungoides
#16
Daniel J Lewis, Madeleine Duvic
Extracorporeal photopheresis (ECP) has been used for nearly 30 years in the treatment of cutaneous T-cell lymphoma. However, current clinical practice largely reserves ECP for patients with late-stage mycosis fungoides (MF) or Sézary syndrome or for those who are refractory to other therapies. We briefly describe a 48-year-old male who experienced long-term complete remission of his patch MF disease with ECP, and we suggest a role for ECP in the treatment of early-stage MF given evidence of its efficacy, safety, and tolerability...
March 24, 2017: Dermatologic Therapy
https://www.readbyqxmd.com/read/28304115/extracorporeal-photopheresis-in-pediatric-patients-practical-and-technical-considerations
#17
Robert A DeSimone, Joseph Schwartz, Jennifer Schneiderman
In adults, extracorporeal photopheresis (ECP) is widely utilized for a variety of indications, most commonly cutaneous T-cell lymphoma, acute or chronic graft-versus-host disease (GVHD), solid organ transplant rejection, and other autoimmune and T-cell-mediated disorders. In pediatric patients, the majority of case series and reports have focused on its use in the management of acute and chronic GVHD. Currently utilized ECP technologies were designed for adult patients and there are several challenges in adapting these technologies for use in children...
March 17, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28271523/safety-and-collection-efficiency-with-a-lower-transfusion-threshold-for-extracorporeal-photopheresis-in-adult-patients-with-graft-versus-host-disease
#18
C Liu, E Schindler, M LeRoy, K Martin-Bredahl, M Dino, K Shah, M Dynis, C S Eby, B J Grossman
BACKGROUND: Extracorporeal photopheresis (ECP) is an established treatment for graft-versus-host disease (GVHD). Various haematocrit thresholds have been used to trigger red blood cells transfusion prior to ECP. Moderate-to-severe GVHD is frequently complicated by anaemia; the safety and collection efficiency with a lower haematocrit for ECP is unknown. METHODS: We prospectively enrolled 26 consecutive adult GVHD patients with haematocrits between 25% and 28·9% who received ECP on the CELLEX system...
May 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28220931/the-role-of-extracorporeal-photopheresis-in-the-management-of-cutaneous-t-cell-lymphoma-graft-versus-host-disease-and-organ-transplant-rejection-a-consensus-statement-update-from-the-uk-photopheresis-society
#19
Arun Alfred, Peter C Taylor, Fiona Dignan, Khaled El-Ghariani, James Griffin, Andrew R Gennery, Denise Bonney, Emma Das-Gupta, Sarah Lawson, Ram K Malladi, Kenneth W Douglas, Tracey Maher, Julie Guest, Laura Hartlett, Andrew J Fisher, Fiona Child, Julia J Scarisbrick
Extracorporeal photopheresis (ECP) has been used for over 35 years in the treatment of erythrodermic cutaneous T-cell lymphoma (CTCL) and over 20 years for chronic and acute graft-versus-host disease (GvHD) and solid organ transplant rejection. ECP for CTCL and GvHD is available at specialised centres across the UK. The lack of prospective randomised trials in ECP led to the development of UK Consensus Statements for patient selection, treatment schedules, monitoring protocols and patient assessment criteria for ECP...
April 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28094112/extracorporeal-photopheresis-for-bronchiolitis-obliterans-syndrome-after-allogeneic-stem-cell-transplant-an-emerging-therapeutic-approach
#20
REVIEW
Claudia Del Fante, Cesare Perotti
Bronchiolitis obliterans syndrome (BOS) is the main manifestation of pulmonary GVHD. It has often a dramatic and fast evolution and current treatment (change or increase in immunosuppression, macrolides and inhaled therapy) is poor with high mortality rates. In this scenario, extracorporeal photopheresis (ECP) bursts as a new immunomodulatory approach with a different philosophical purpose. In fact, available data show that ECP treatment is intended to delay the inflammatory process and consequently respiratory lung function decline, rather than reverse the damage itself...
February 2017: Transfusion and Apheresis Science
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