Extracorporeal Photopheresis (ECP) treatment

ECP is a standard treatment for a blood cancer that affects the skin. It's also used to treat graft-versus-host disease (GVHD) that hasn't gotten better after steroid treatment. During ECP, your blood is collected and treated in a machine. The machine adds a chemical that makes the white blood cells sensitive to light. Then the machine shines a light on the cells and then gives your blood back to you.

People with GVHD who have not gotten better after treatment with steroids are at risk of getting ECP.

• Large veins or a central line. Good intravenous (IV) access is needed to collect your blood and give it back to you after treatment. If you have small or scarred veins you may need a central line (central venous catheter) to get ECP. A central line is a long, thin tube that’s put into the large vein in your chest. It either comes out through your skin, or ends in a port just under your skin. It’s used to give medicines, fluid and blood.
• Time. ECP can take 1 to 4 hours to complete depending on the machine used. Most people need treatment for 2 to 3 days every week or month.
• Enough blood counts. You must have enough platelets and red blood cells to get ECP treatment. If your platelet or red blood cell count is low, your doctors may delay your ECP treatment. Or, you may need blood transfusions to increase your blood counts.

ECP may take a long time to have its best effect. Your doctor may wait 2 to 3 months before deciding whether ECP is helping you.

• ECP is also called extracorporeal photochemotherapy or extracorporeal photoimmunotherapy.
• No one knows exactly how ECP treats GVHD. Some researchers have found changes in the blood after ECP that decreases swelling and inflammation.
• ECP may have a lower risk of infections than other GVHD treatments, like steroids or medicines that hold back (suppress) your immune system.
• You will be more sensitive to the sun for 24 hours after treatment. Avoid the sun and wear sunscreen. You should also protect your eyes and wear protective sunglasses.
• Long-term treatment with ECP can cause low red blood cell counts (anemia) and fatigue due to lack of iron. Your doctor can test you for this and give you iron pills or infusions if needed.
• ECP is expensive and not all insurance companies will cover it. So you may have out-of-pocket costs with this treatment.

• You have a central line and your arm swells or you feel short of breath. You could have a blood clot.
• You had treatment within the past 1 to 2 days and have a fever, chills or feel unwell. You could have an infection.
• Your GVHD gets worse despite treatment.

A clinical trial may offer a GVHD treatment option for you. NMDP^SM facilitates clinical trials through the Jason Carter Clinical Trials Search and Support program. Find out whether joining one might improve your treatment outcomes.