Extracorporeal Photopheresis in Patients with Chronic Graft-Versus-Host Disease

Chronic graft-versus-host disease (cGvHD) is a potentially life-threatening complication following allogeneic hematopoietic stem cell transplantation. Despite significant advancements in this field, cGvHD remains a major cause of morbidity and mortality among transplant recipients. Extracorporeal photopheresis (ECP) has emerged as a promising therapeutic option for managing cGvHD. Several clinical studies and case series have demonstrated the efficacy of ECP in treating cGvHD, including its ability to reduce the overall burden of the disease and its steroid-sparing effects. However, challenges remain, such as determining optimal patient selection, treatment protocols, timing, session duration, accessibility, and cost-effectiveness. ECP represents a valuable therapeutic approach, offering immunomodulatory effects and a favorable safety profile for patients with cGvHD. Further research and larger-scale prospective studies are needed to address these challenges, elucidate its mechanism of action, and explore combination strategies.