Feasibility and safety of a new technique of extracorporeal photochemotherapy: experience of 240 procedures

Background and Objective. Extracorporeal photochemotherapy (ECP) is a thera peutic approach based on the biological effects of ultraviolet light (UV)-A and psoralens on mononuclear cells collected by apheresis. Recently, ECP h as been under investigation as an alternative treatment for various immune and autoimmune diseases. The aim of this study was to evaluate the Safety a nd feasibility of a new three-step ECP technique, in terms of reproducibili ty, acceptance, tolerability, and short and long term side effects. Design and Methods. Seventeen patients affected by acute or chronic graft-v ersus-host disease (GVHD), pemphigus vulgaris, or interferon-resistant chro nic hepatitis C and one patient being treated for prevention of heart trans plant rejection underwent 240 ECP procedures. MNC collection and processing parameters were recorded, biological effects of UV-A/8 methoxy-psoralen (8 -MOP) were evaluated, and short and long term side effects were monitored. Results. At a mean follow up of 7 months (range 2-19) 240 ECP had been comp leted, a mean of 7,136 mL (range 1,998-10,591) of whole blood having been-p rocessed per procedure. The mean of total nucleated cells collected per pro cedure was 6.5x10(9) (range 0.65-23.8), with a mean MNC percentage of 85% ( 41.4-98%) in a mean final volume of 115.5 mt (37-160). No severe side effec ts were documented and no infectious episodes occurred throughout the cours e of the treatment. Interpretation and Conclusions. The new ECP technique was highly reproducib le as regards the collection and each processing step. Short and long term side effects were mild. No increase in infectious episodes was recorded. Al l patients willingly underwent ECP, demonstrating an excellent tolerability for the procedure even after several courses. (C) 1999, Ferrata Storti Fou ndation.