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Extracorporeal photopheresis as an immunomodulatory treatment modality for chronic GvHD and the importance of emerging biomarkers

Lookup NU author(s): Dr Aisling Flinn, Kimberly Schell, Professor Andrew GenneryORCiD, Dr Rachel CrosslandORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Copyright © 2023 Bojanic, Worel, Pacini, Stary, Piekarska, Flinn, Schell, Gennery, Knobler, Lacerda, Greinix, Pulanic and Crossland. Haematopoietic stem cell transplantation (HSCT) is the treatment of choice for malignant haematological diseases. Despite continuous improvements in pre- and post-transplantation procedures, the applicability of allo-HSCT is limited by life-threatening complications such as graft-versus-host disease (GvHD), engraftment failure, and opportunistic infections. Extracorporeal photopheresis (ECP) is used to treat steroid resistant GvHD with significant success. However, the molecular mechanisms driving its immunomodulatory action, whilst preserving immune function, require further understanding. As ECP is safe to administer with few significant adverse effects, it has the potential for earlier use in the post-HSCT treatment of GvHD. Thus, further understanding the immunomodulatory mechanisms of ECP action may justify more timely use in clinical practice, as well as identify biomarkers for using ECP as first line or pre-emptive GvHD therapy. This review aims to discuss technical aspects and response to ECP, review ECP as an immunomodulatory treatment modality for chronic GvHD including the effect on regulatory T cells and circulating vs. tissue-resident immune cells and consider the importance of emerging biomarkers for ECP response.

Publication metadata

Author(s): Bojanic I, Worel N, Pacini CP, Stary G, Piekarska A, Flinn AM, Schell KJ, Gennery AR, Knobler R, Lacerda JF, Greinix HT, Pulanic D, Crossland RE

Publication type: Review

Publication status: Published

Journal: Frontiers in Immunology

Year: 2023

Volume: 14

Online publication date: 17/02/2023

Acceptance date: 01/02/2023

ISSN (electronic): 1664-3224

Publisher: Frontiers Media S.A.


DOI: 10.3389/fimmu.2023.1086006

PubMed id: 36875063