Article information
Abstract
Extracorporeal photochemotherapy or photopheresis is an immunomodulatory therapy that combines leukapheresis with phototherapy. Blood from the patient is processed to give a leukocyte-rich plasma, which is then treated ex vivo with a photosensitizer and ultraviolet A radiation before reinfusion back into the patient. The exact mechanism of action of photopheresis has not been fully elucidated although it is thought that induction of leukocyte apoptosis and formation of dendritic cells is essential for the development of an immune response to pathogenic cells. Extracorporeal photopheresis was initially used for treating cutaneous T-cell lymphoma. Since then, in view of its efficacy and safety, it has been used in a number of cutaneous and non cutaneous diseases with uneven results, which can in part be explained by the different patient selection criteria, therapy regimens, and follow-up protocols used in different hospitals.
Key words:
photopheresis
photochemotherapy
extracorporeal
treatment
Resumen
La fotoquimioterapia extracorpórea o fotoféresis es una terapia inmunomoduladora que combina la leucoféresis con la fototerapia. Después de la separación de un plasma rico en leucocitos, se administra ex vivo un fotosensibilizante junto con radiación ultravioleta A y posteriormente se reinfunde en el paciente. El mecanismo de acción exacto de la fotoféresis no se conoce completamente, aunque se piensa que la inducción de apoptosis de linfocitos y la formación de células dendríticas desempeña un papel fundamental en el desarrollo de una respuesta inmunológica contra las células patógenas. Esta terapia se utilizó inicialmente para el tratamiento del linfoma cutáneo de células T. Desde entonces, basándose en su eficacia y seguridad, se ha empleado en múltiples patologías tanto cutáneas como no cutáneas, con resultados variables. Los distintos centros han utilizado diferentes criterios de selección de pacientes, pautas de tratamiento y protocolos de monitorización, lo que podría contribuir a la diferencia de resultados.
Palabras clave:
fotoféresis
fotoquimioterapia
extracorpórea
tratamiento
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References
[1.]
R.L. Edelson.
Photopheresis: a new therapeutic concept.
Yale J Biol Med, 62 (1989), pp. 565-577
[3.]
Díez-Recio E. Fotoquimioterapia extracorpórea en enfermedades no linfoproliferativas. Director: Antonio Harto Castaño. Tesis doctoral. Universidad de Alcalá de Henares. Departamento de Medicina. 2004.
[4.]
E.K. Yoo, A.H. Rook, R. Elenitsas, F.P. Gasparro, B.R. Vowels.
Apoptosis induction by ultraviolet light A and photochemotherapy in cutaneous T-cell lymphoma: relevance to mechanism of therapeutic action.
J Invest Dermatol, 108 (1996), pp. 235-242
[5.]
F. Heshmati, G. Andreu.
Extracorporeal photochemotherapy: a historical perspective.
Transfus Apheresis Sci, 28 (2003), pp. 25-34
[6.]
L.E. French, A.H. Rook.
T cell clonality and the effect of photopheresis in systemic sclerosis and graft versus host disease.
Transfus Apheresis Sci, 26 (2002), pp. 191-196
[7.]
A.H. Rook, K.R. Suchin, D.M.F. Kao, E.K. Yoo, W.H. Macey, B.J. DeNardo, et al.
Photopheresis: clinical applications and mechanism of action.
J Invest Dermatol Symp Proc, 4 (1999), pp. 85-90
[8.]
A.R. Tambur, J.W. Ortegel, A. Morales, H. Klingemann, H.M. Gebel, M.D. Tharp.
Extracorporeal photopheresis induces lymphocyte but not monocyte apoptosis.
Transplant Proc, 32 (2000), pp. 747-748
[9.]
M. Salskov-Iversen, C.L. Berger.
Rapid construction of dendritic cell vaccine through physical perturbation and apoptotic malignant T cell loading.
J Immune Based Ther Vaccines, 3 (2005), pp. 4
[10.]
R. Spisek, Z. Gasova, J. Bartunkova.
Maturation state of dendritic cells during the extracorporeal photopheresis and its relevance for the treatment of chronic graft-versus-host disease.
Transfusion, 46 (2006), pp. 55-65
[11.]
C.L. Berger, A.L. Xu, D. Hanlon, C. Lee, J. Schechner, E. Glusac, I. Christensen, E. Snyder, V. Holloway, R. Tigelaar, R.L. Edelson.
Induction of human tumor-loaded dendritic cells.
Int J Cancer, 91 (2001), pp. 438-447
[12.]
M. Di Renzo, P. Rubegni, G. De Aloe, L. Paulesu, A.L. Pasqui, L. Andreassi, et al.
Extracorporeal photochemotherapy restores Th1/Th2 imbalance in patients with early stage cutaneous T-cell lymphoma.
Immunology, 92 (1997), pp. 99-103
[13.]
A.H. Rook, M. Kubin, M. Cassin, E.C. Vonderheid, B.R. Vowels, J.T. Wolfe, et al.
IL 12 reverses cytokine and immune abnormalities in Sezary syndrome.
J Immunol, 154 (1995), pp. 1491-1498
[14.]
C.L. Berger, D. Hanlon, D. Kanada, M. Girardi, R.L. Edelson.
Transimmunization, a novel approach for tumor immunotherapy.
Transfus Apher Sci, 26 (2002), pp. 205-216
[15.]
M. Giardi, C.L. Berger, L.D. Wilson.
Transimmunization for cutaneous T cell lymphoma: A phase I study.
Leuk Lymphoma, 47 (2006), pp. 1495-1503
[16.]
M.G. Roncarolo, S. Gregori, M. Battaglia, I.R. Christensen, K.R. Thompson, E.J. Glusac, et al.
Interleukin-10-secreting type 1 regulatory T cells in rodents and humans.
Immunol Rev, 212 (2006), pp. 28-50
[17.]
G. Gorgun, K.B. Miller, F.M. Foss.
Immunologic mechanism of extracorporeal photochemotherapy in chronic graftversus-host disease.
Blood, 100 (2002), pp. 941-947
[18.]
Azaña Defez JM. Nuevas aplicaciones de la fotoquimioterapia extracorpórea. Estudio clínico. Director: Antonio Ledo Pozueta. Tesis doctoral. Universidad de Alcalá de Henares. Facultad de Medicina. Departamento de Medicina. 1995.
[19.]
R. Edelson, C. Berger, F. Gasparro.
Treatment of cutaneous T-cell lymphoma by extracorporeal photochemotherapy: preliminary results.
N Engl J Med, 31 (1987), pp. 297-303
[20.]
B.R. Vowels, M. Berkson, J. Cohen.
Extracorporeal photochemotherapy does not suppress T or B cell responses to novel or recall antigens.
J Invest Dermatol, 98 (1992), pp. 605
[21.]
J.J. Scarisbrick, P. Taylor, U. Holtick, Y. Makar, K. Douglas, G. Berlin, et al.
U.K. consensus statement on the use of extracorporeal photopheresis for treatment of cutaneous T-cell lymphoma and chronic graft-versus-host disease.
Br J Dermatol, 158 (2008), pp. 659-678
[22.]
F. Gallardo, R.M. Pujol.
Diagnóstico y tratamiento de los linfomas cutáneos de células T primarios.
Actas Dermosifiliograf, 95 (2004), pp. 473-490
[23.]
J.A. Zic, G.P. Stricklin, J.P. Greer, A. Looks, A. Stuhlert, D. Lange.
Long-term follow-up of cutaneous T-cell lymphoma patients treated with extracorporeal photochemotherapy.
J Am Acad Dermatol, 35 (1996), pp. 935-945
[24.]
K.E. McKenna, S. Whittaker, L.E. Rhodes, P. Taylor, J. Lloyd, S. Ibbotson, et al.
Evidence-based practice of photopheresis 1987-2001: a report of a workshop of the British Photodermatology Group and the U.K. Skin Lymphoma Group.
Br J Dermatol, 154 (2006), pp. 7-20
[25.]
E.C. Vonderheid, Q. Zhang, S.R. Lessin, M. Polansky, J.T. Abrams, R.D. Bigler, et al.
Use of serum soluble interleukin-2 receptor levels to monitor the progression of cutaneous T-cell lymphoma.
J Am Acad Dermatol, 38 (1998), pp. 207-220
[26.]
R.F. De Misa, M. Azaña, A. Harto, R. Moreno.
Extracorporeal photochemotherapy for treatment of cutaneous T-cell lymphoma.
Actas Dermosifiliogr, 78 (1987), pp. 7-69
[27.]
A.V. Evans, B.P. Wood, J.J. Scarisbrick.
Extracorporeal photopheresis in Sézary syndrome: hematologic parameters as predictors of response.
Blood, 98 (2001), pp. 1298-1301
[28.]
S.L. Gottlieb, J.T. Wolfe, F.E. Fox, B.J. DeNardo, W.H. Macey, P.G. Bromley, et al.
Treatment of cutaneous T-cell lymphoma with extracorporeal photopheresis monotherapy and in combination with recombinant interferon alfa: a 10 year experience at a single institution.
J Am Acad Dermatol, 35 (1996), pp. 946-957
[29.]
S.B. Jiang, S.B. Dietz, M. Kim, H.W. Lim.
Extracorporeal photochemotherapy for cutaneous T-cell lymphoma: a 9.7-year experience.
Photodermatol Photoimmunol Photomed, 15 (1999), pp. 161-165
[30.]
U. Wollina, A. Looks, J. Meyer, B. Knopf, H.J. Koch, K. Liebold, et al.
Treatment of stage II cutaneous T-cell lymphoma with interferon alfa-2a and extracorporeal photochemotherapy: a prospective controlled trial.
J Am Acad Dermatol, 44 (2001), pp. 253-260
[31.]
E. Fraser-Andrews, P. Seed, S. Whittaker, R. Russell-Jones.
Extracorporeal photopheresis in Sezary Syndrome. No significant effect in the survival of 44 patients with a peripheral blood T-cell clone.
Arch Dermatol, 134 (1998), pp. 1001-1005
[32.]
K.R. Suchin, A.J. Cucchiara, S.L. Gottleib, J.T. Wolfe, B.J. DeNardo, W.H. Macey, et al.
Treatment of cutaneous T-cell lymphoma with combined immunomodulatory therapy: a 14-year experience at a single institution.
Arch Dermatol, 138 (2002), pp. 1054-1060
[33.]
M. Duvic, N. Chiao, R. Talpur.
Extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma.
J Cutan Med Surg, 7 (2003), pp. 3-7
[34.]
J.A. Zic.
The treatment of cutaneous T-cell lymphoma with photopheresis.
Dermatol Ther, 16 (2003), pp. 337-346
[35.]
J.D. Miller, E.B. Kirkland, D. Santo Domingo, H. Scull, B. Jekutis, M. Dallas, et al.
Review of extracorporeal photopheresis in early-stage (IA, IB and IIA) cutaneous T-cell lymphoma.
Photodermatol Photoimmunol Photomed, 23 (2007), pp. 163-171
[36.]
F.J. Child, T.J. Mitchell, S.J. Whittaker, J.J. Scarisbrick, P.T. Seed, R. Russell-Jones.
A randomized cross-over study to compare PUVA and extracorporeal photopheresis in the treatment of plaque stage (T2) mycosis fungoides.
Clin Ex Dermatol, 29 (2004), pp. 231-236
[37.]
R. De Misa, A. Harto, J.M. Azaña, P. Belmar, E. Díez, A. Ledo.
Photopheresis does not improve survival in Sézary syndrome patients with bone marrow involvement.
J Am Acad Dermatol, 53 (2005), pp. 171-172
[38.]
M. Owsianowski, H. Gollnick, W. Siegert, R. Schwerdtfeger, C.E. Orfanos.
Successful treatment of chronic graft-versus-host disease with extracorporeal photopheresis.
Bone Marrow Transplant, 14 (1994), pp. 845-848
[39.]
S.R. Marshall.
Technology insight: ECP for the treatment of GvHD–can we offer selective immune control without generalized immunosuppression?.
Nat Clin Pract Oncol, 3 (2006), pp. 302-314
[40.]
R. Dall’Amico, C. Messina.
Extracorporeal photochemotherapy for the treatment of graft-versus-host disease.
Transfus Apher Sci, 6 (2002), pp. 296-304
[41.]
H.T. Greinix, B. Volc-Platzer, R.M. Knobler.
Extracorporeal photochemotherapy in the treatment of severe graft-versushost disease.
Leuk Lymphoma, 36 (2000), pp. 425-434
[42.]
C. Messina, F. Locatelli, E. Lanino, C. Uderzo, G. Zacchello, S. Cesaro, et al.
Extracorporeal photochemotherapy for paediatric patients with graft-versus-host disease after haematopoietic stem cell transplantation.
Br J Dermatol, 122 (2003), pp. 118-127
[43.]
J. Kanold, C. Paillard, P. Halle.
Extracorporeal photochemotherapy for graft-versus-host disease in paediatric patients.
Transfus Apher Sci, 28 (2003), pp. 71-80
[44.]
F.M. Foss, G.M. DiVenuti, K. Chin, K. Sprague, H. Grodman, A. Klein, et al.
Prospective study of extracorporeal photopheresis in steroid-refractory or steroid-resistant extensive chronic graft-versus-host disease: analysis of response and survival incorporating prognostic factors.
Bone Marrow Transplant, 35 (2005), pp. 1187-1193
[45.]
L. Bagazgoitia, J.L. Santiago, A. Harto, P. Jaén.
Enfermedad injerto contra huésped tratada con fotoféresis: a propósito de un caso.
Actas Dermosifiliogr, 99 (2008), pp. 168-169
[46.]
J.H. Antin, A.R. Chen, D.R. Couriel, V.T. Ho, R.A. Nash, D. Weisdorf.
Novel approaches to the therapy of steroid-resistant acute graft-versus-host disease.
Biol Blood Marrow Transplant, 10 (2004), pp. 655-668
[47.]
H.T. Greinix, B. Volc-Platzer, P. Kalhs, G. Fischer, A. Rosenmayr, F. Keil, et al.
Extracorporeal photochemotherapy in the treatment of severe steroid refractory acute graft-versus-host disease: a pilot study.
Blood, 96 (2000), pp. 2426-2431
[48.]
H.T. Greinix, R.M. Knobler, N. Worel, B. Schneider, A. Schneeberger, P. Hoecker, et al.
The effect of intensified extracorporeal photochemotherapy on long-term survival in patients with severe acute graft-versus-host disease.
Haematologica, 91 (2006), pp. 405-408
[49.]
E.P. Smith, I. Sniecinski, A.C. Dagis, P.M. Parker, D.S. Snyder, A.S. Stein, et al.
Extracorporeal photochemotherapy for treatment of drug-resistant graft-vs-host disease.
Biol Blood Marrow Transplant, 4 (1998), pp. 27-37
[50.]
A.H. Rook, B. Freundlich, G.T. Nahass, R. Washko, B. Macelis, M. Skolnicki, et al.
Treatment of autoinmmune disease with extracorporeal photochemotherapy: progressive systemic sclerosis.
Yale J Biol Med, 62 (1989), pp. 639-645
[51.]
A.H. Rook, B. Freundlich, B.V. Jegasothy.
Treatment of systemic sclerosis with extracorporeal photochemotherapy. Result of a multicenter trial.
Arch Dermatol, 128 (1992), pp. 337-346
[52.]
D.E. Trentham.
Photochemotherapy in systemic sclerosis. The stage is set.
Arch Dermatol, 128 (1992), pp. 389-390
[53.]
H. Zachariae, P. Bjerring, L. Heickendorff, B. Møller, K. Wallevik.
Photopheresis and systemic sclerosis.
Arch Dermatol, 128 (1992), pp. 1651-1653
[54.]
H. Zachariae, P. Bjerring, L. Heickendorff, B. Møller, K. Wallevik, H. Angelo.
Photopheresis in systemic sclerosis: clinical and serological studies using markers of collagen metabolism.
Acta Derm Veneorol, 73 (1993), pp. 356-361
[55.]
D.N.H. Enonoto, J.R. Mekkes, P.M.M. Bossuyt, S. Yong, T.A. Out, J.D. Bos.
Treatment of patients with systemic sclerosis with extracorporeal photochemotherapy (photopheresis).
J Am Acad Dermatol, 41 (1999), pp. 915-922
[56.]
B. Cribier, T. Faradji, C. Le Coz, F. Oberling, E. Grosshans.
Extracorporeal photochemotherapy in systemic sclerosis and severe morphea.
Dermatology, 191 (1995), pp. 25-31
[57.]
J.A. Zic, J.L. Miller, G.P. Stricklin, L.E. King Jr.
The North American experience with photopheresis.
Ther Apher, 3 (1999), pp. 50-62
[58.]
F.X. Di Spaltro, C. Cotrill, C. Cahill, E. Degnan, G.J. Mulford, D. Scarborough, et al.
Extracorporeal photochemotherapy in progressive systemic sclerosis.
Int J Dermatol, 32 (1993), pp. 417-421
[59.]
K. Krasagakis, E. Dippel, J. Ramaker, M. Owsianowski, C.E. Orfanos.
Management of severe scleroderma with long-term extra-corporeal photopheresis.
Dermatology, 196 (1998), pp. 309-315
[60.]
R. Knobler, L.E. French, Y. Kim, E. Bisaccia, W. Graninger, H. Nahavandi, et al.
A randomized, double-blind, placebo-controlled trial of photopheresis in systemic sclerosis.
J Am Acad Dermatol, 54 (2006), pp. 793-799
[61.]
L.E. French, S.R. Lessin, K. Addya, B. Denardo, D.J. Margolis, D.G. Leonard, et al.
Identification of clonal T cells in the blood of patients with systemic sclerosis. Positive correlation with response to photopheresis.
Arch Dermatol, 13 (2001), pp. 1309-1313
[62.]
B. Prinz, F. Nachbar, G. Plewig.
Treatment of severe atopic dermatitis with extracorporeal photopheresis.
Arch Dermatol Res, 287 (1994), pp. 48-52
[63.]
B. Prinz, S. Michelsen, C. Pfeiffer, G. Plewig.
Long-term application of extracorporeal photochemotherapy in severe atopic dermatitis.
J Am Acad Dermatol, 40 (1999), pp. 577-582
[64.]
M. Radenhausen, G. von Kobylezki, S. Höxtermann, P. Altmeyer, K. Hoffmann.
Activation markers in severe atopic dermatitis following extracorporeal photochemotherapy.
Acta Dermatol Venereol, 83 (2003), pp. 49-79
[65.]
H.I. Ritcher, C. Billmann-Eberwein, M. Grewe, H. Stege, M. Berneburg, T. Ruzicka, et al.
Successful monotherapy of severe and intractable atopic dermatitis by photopheresis.
J Am Acad Dermatol, 38 (1998), pp. 585-588
[66.]
G. Mohla, N. Horvath, S. Stevens.
Quality of life improvement in a patient with severe atopic dermatitis treated with photopheresis.
J Am Acad Dermatol, 40 (1999), pp. 780-782
[67.]
P.A. Bécherel, A. Bussel, O. Chosidow, C. Rabian, J.C. Piette, C. Francès.
Extracorporeal photochemotherapy for chronic erosive lichen planus.
Lancet, 351 (1998), pp. 805
[68.]
A.D. Guyot, D. Farhi, S. Ingen-Housz-Oro, A. Bussel, N. Parquet, C. Rabian, et al.
Treatment of refractory erosive oral lichen planus with extracorporeal photochemotherapy: 12 cases.
Br J Dermatol, 156 (2007), pp. 553-556
[69.]
A.H. Rook, B.V. Jegasothy, P. Heal, W. Macey, W.K. Witmer, G.S. Lazarus, et al.
Extracorporeal photochemotherapy for drug-resistant pemphigus vulgaris.
Ann Intern Med, 112 (1990), pp. 303-305
[70.]
G. Liang, G. Nahass, F.A. Kerdel.
Pemphigus vulgaris treated with photopheresis.
J Am Acad Dermatol, 26 (1992), pp. 779-780
[71.]
H.PM. Gollnick, M. Owsianowski, K.M. Taube.
Unresponsive severe generalized pemphigus vulgaris successfully controlled by extracorporeal photopheresis.
J Am Acad Dermatol, 28 (1993), pp. 122-124
[72.]
U. Wollina, D. Lange, A. Looks.
Short-time extracorporeal photochemotherapy in the treatment of drug-resistant autoimmune bullous diseases.
Dermatology, 198 (1999), pp. 140-144
[73.]
A. Litch-Mbalyohere, A. Heller, R. Stadler.
Extracorporeal photochemotherapy of therapy-refractory cases of systemic lupus erythematous with urticarial vasculitis and pemphigus foliaceus.
Eur J Dermatol, 6 (1996), pp. 106-109
[74.]
J.M. Azaña, R.F. De Misa, A. Harto.
Severe pemphigus foliaceus treated with extracorporeal photochemotherapy.
Arch Dermatol, 133 (1997), pp. 287-289
[75.]
E.C. Vonderheid, R.D. Bigler, T.J. Rogers, M.E. Kadin, T.D. Griffin.
Effects of extracorporeal photopheresis on selected immunologic parameters in psoriasis.
Yale J Biol Med, 62 (1989), pp. 653-664
[76.]
E.C. Vonderheid, C. Kang, M. Kadin, R.D. Bigler, T.D. Griffin, T.J. Rogers.
Extracorporeal photopheresis in psoriasis vulgaris: clinical and immunologic observations.
J Am Acad Dermatol, 23 (1990), pp. 703-712
[77.]
A. De Wilde, F.X. DiSpaltro, A. Geller, I.S. Szer, A.S. Klainer, E. Bisaccia.
Extracorporeal photochemotherapy as adjunctive treatment in juvenile dermatomyositis: a case report.
Arch Dermatol, 128 (1992), pp. 1656-1657
[78.]
R.M. Knobler, W. Graninger, W. Graninger, A. Lindmaier, F. Trautinger, J.S. Smolen.
Extracorporeal photochemotherapy for the treatment of systemic lupus erythematosus. A pilot study.
Arthritis Rheum, 35 (1992), pp. 319-324
[79.]
K.B. Gordon, L.S. Chan, D.T. Woodley.
Treatment of refractory epidermolysis bullosa acquisita with extracorporeal photochemotherapy.
Br J Dermatol, 136 (1997), pp. 415-420
[80.]
J.L. Miller, G.P. Stricklin, J.D. Fine, L.E. King, M.C. Arzubiaga, D.L. Ellis.
Remission of severe epidermolysis by extracorporeal photochemotherapy.
Br J Dermatol, 133 (1995), pp. 467-471
[81.]
G.I. Stables, P.C. Taylor, A.S. Highet.
Scleredema associated with paraproteinaemia treated by extracorporeal photopheresis.
Br J Dermatol, 142 (2000), pp. 781-783
[82.]
K. Krasagakis, C.C. Zouboulis, M. Owsianowski.
Remission of scleromyxoedema following treatment with extracorporeal photopheresis.
Br J Dermatol, 135 (1996), pp. 463-466
[83.]
M. Berkson, G.S. Lazarus, M. Uberti-Berz, A.H. Rook.
Extracorporeal photochemotherapy: a potentially useful treatment for scleromyxedema.
J Am Acad Dermatol, 25 (1991), pp. 724
[84.]
C. Romano, P. Rubegni, G. De Aloe, E. Stanghellini, G. D’Ascenzo, L. Andreassi, et al.
Extracorporeal photochemotherapy in the treatment of eosinophilic fasciitis.
J Eur Acad Dermatol Venereol, 17 (2003), pp. 10-13
[85.]
H.A. Haenssle, H.P. Bertsch, S. Emmert, C. Wolf, M. Zutt.
Extracorporeal photochemotherapy for the treatment of exanthematic pityriasis rubra pilaris.
Clin Exp Dermatol, 29 (2004), pp. 244-246
[86.]
R. Mang, H. Stege, M.A. Budde, T. Ruzicka, J. Krutmann.
Successful treatment of solar urticaria by extracorporeal photo-chemotherapy (photopheresis)–a case report.
Photodermatol Photoimmunol Photomed, 18 (2002), pp. 196-198
[87.]
M. Gilliet, A. Cozzio, G. Burg, F.O. Nestle.
Successful treatment of three cases of nephrogenic fibrosing dermopathy with extracorporeal photopheresis.
Br J Dermatol, 152 (2005), pp. 531-536
[88.]
M. Duvic, J.P. Hester, A. Lemak.
Photopheresis therapy for cutaneous T-cell lymphoma.
J Am Acad Dermatol, 35 (1996), pp. 573-579
[89.]
T.M. Fritz, M. Kleinhans, F.O. Nestle.
Combination treatment with extracorporeal photopheresis, interferon alfa and interleukin 2 in a patient with Sézary syndrome.
Br J Dermatol, 140 (1999), pp. 1144-1147
[90.]
E. Bisaccia, J. González, M. Palangio.
Extracorporeal photochemotherapy alone or with adjuvant therapy in the treatment of cutaneous T-cell lymphoma: a 9-year retrospective study of a single institution.
J Am Acad Dermatol, 43 (2000), pp. 263-271
[91.]
G. Crovetti, A. Carabelli, E. Berti, M. Guizzardi, S. Fossati, C. De Filippo, E. Bertani.
Photopheresis in cutaneous T-cell lymphoma: five-year experience.
Int J Artif Organs, 23 (2000), pp. 55-62
[92.]
D. Rossetti, R. Dall’Amico, G. Crovetti, C. Messina, G. Montini, G. Dini, et al.
Extracorporeal photochemotherapy for the treatment of graft-versus-host disease.
Bone Marrow Transplant, 18 (1996), pp. 175-181
[93.]
L. Slavaneschi, C. Perotti, M. Zecca.
Extracorporeal photochemotherapy for treatment of acute and chronic GVHD in childhood.
Transfusion, 41 (2001), pp. 1299-1305
[94.]
N. Apisarnthanarax, M. Donato, M. Körbling, D. Couriel, J. Gajewski, S. Giralt, et al.
Extracorporeal photopheresis therapy in the management of steroid-refractory or steroid-dependent cutaneous chronic graft-versus-host disease after allogeneic stem cell transplantation: feasibility and results.
Bone Marrow Transplant, 31 (2003), pp. 459-465
[95.]
P. Perseghin, S. Galimberti, A. Balduzzi, S. Bonanomi, V. Baldini, A. Rovelli, M. Dassi, A. Rambaldi, L. Castagna, P. Corti, E.M. Pogliani, C. Uderzo.
Extracorporeal photochemotherapy for the treatment of chronic graft-versus-host disease: trend for a possible cell dose-related effect?.
Ther Apher Dial, 11 (2007), pp. 85-93
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