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Photopheresis

(Also Called 'ECP (Extracorporeal Photoimmune)', 'Extracorporeal Photoimmune Therapy')

What is photopheresis?

Photopheresis or extracorporeal photoimmune therapy is a procedure that might be recommended by your doctor to prevent or to treat graft versus host disease (GvHD). This procedure offers another way to try to suppress the donor lymphocytes (type of white blood cells) that stimulate immune reactions and aid in the development of GvHD.

How long does the procedure last?

The photopheresis process lasts about 3 to 4 hours. You might require several photopheresis sessions before the desired results are achieved. Your doctor will develop an individual treatment plan for you based on your disease.

How is photopheresis done?

During photopheresis, blood is taken from one lumen of your central venous catheter and processed through a cell separation machine. This machine removes and treats your lymphocytes and then returns them and the rest of your blood through a different lumen in your central venous catheter.

When your blood first enters the machine, it is mixed with an anticoagulant medicine to prevent it from clotting. Then, the cell separation machine collects the lymphocytes from your blood and mixes them with the drug 8-methoxypsoralen or UVADEX. This is a photosensitizing agent that becomes active when it is exposed to ultraviolet light. The lymphocytes and UVADEX are next exposed to ultraviolet A light inside the machine. Lastly, the lymphocytes and the rest of your blood are re-infused to you through another lumen in your catheter.

How can this procedure help me?

By treating your lymphocytes during photopheresis, their function is altered. When the treated lymphocytes are re-infused, they will stimulate an immune response in your body to fight the development or progression of GvHD. Your doctor might use photopheresis alone or in combination with other treatments.

How will I feel during the photopheresis process?

You will lay comfortably in bed during the photopheresis procedure while your blood is taken, processed, and then re-infused. Photopheresis is a painless procedure.

Changes in blood volume might cause you to feel dizzy or light-headed. Also, you might feel cold, experience a tingling sensation around your lips or fingers, or might even feel cramps in your legs. Tell your nurse if you experience any of these symptoms, and he or she will help relieve your discomfort.

What are the side effects?

A few patients might experience a slight drop in blood pressure during the procedure. This is easily corrected by receiving intravenous fluids.

Another possible side effect is fever about 6 to 8 hours after the procedure. Please tell your doctor if you have a temperature over 100° F. Your doctor might recommend you take additional medicines such as acetaminophen (Tylenol®).

Precautions after treatment

You must avoid sunlight, even if it's indirect sunlight, for 24 hours after each procedure since you will be more sensitive to the sun. If you go outside, please apply sunscreen with at least SPF 15. Please wear UVA protective sunglasses in a "wraparound" style to protect the sides of your eyes. UVA sunglasses are available in many colors, including clear, at most drug stores for about $20. It is recommended that you wear these both inside and outside for 24 hours after each procedure.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/1/2007...#10252


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