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Blood, 1 September 2001, Vol. 98, No. 5, pp. 1622-1625
BRIEF REPORT
Immunomodulatory effects of extracorporeal photochemotherapy in
patients with extensive chronic graft-versus-host disease
Thierry Alcindor,
Gullu Gorgun,
Kenneth B. Miller,
Todd F. Roberts,
Kellie Sprague,
David P. Schenkein, and
Francine M. Foss
From the Division of Hematology/Oncology and Bone
Marrow Transplantation, Tupper Research Institute, Tufts-New England
Medical Center, Boston, MA.
Extracorporeal photochemotherapy (ECP) has been associated with
clinical improvement in several patients with acute and chronic graft-versus-host disease (cGVHD) after allogeneic bone marrow transplantation, but the mechanism of action is unknown. This study tested the hypothesis that in patients with cGVHD, ECP
modulates alloreactivity by affecting activated lymphocyte populations
or by altering the interaction between effector lymphocytes and
antigen-presenting cells (APCs). Ten patients who had refractory cGVHD
were treated with ECP, and the clinical response to and immunologic
effects of this therapy were assessed. Seven patients had a
response and 3 had no change in clinical manifestations of cGVHD. One
patient died from catheter-related sepsis. Immunologic effects observed after ECP included normalization of inverted ratios of CD4 to CD8
cells, an increase in the number of CD3-CD56+ natural
killer (NK) cells, and a decrease in CD80+ and
CD123+ circulating dendritic cells. The results suggest
that ECP modulates both NK cells and APC populations in patients with cGVHD.
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