Division of Dermatology, Vanderbilt University School of Medicine, Nashville, Tennessee 37204, USA.
Curr Opin Oncol. 2012 Jan;24 Suppl 1:S1-10. doi: 10.1097/01.cco.0000410158.56500.c4.
Cutaneous T-cell lymphoma is the overall name for a group of malignancies in which malignant T-lymphocytes localize at the skin. Of the current 20 recognized subtypes of the disease, the most common are mycosis fungoides and Sézary syndrome. Extracorporeal photopheresis (ECP), an immunomodulating procedure that treats pheresed blood with a photoactive agent, received US Food and Drug Administration approval in 1988 as a medical device for the treatment of CTCL patients, one of many treatment options for such patients. This was followed in 2003 by guidelines in the United Kingdom that recommended ECP for patients with advanced CTCL, particularly after skin-directed treatment options have failed. ECP is now under investigation for use in patients with earlier stages of CTCL. This article reviews the evolution of the ECP technique--for example, the most recent generation of the device requires a lower extracorporeal volume of blood than the previous version did, thus making it possible for more patients to be candidates for the procedure. In addition, there has been progress in understanding how ECP works at the cellular level.
皮肤 T 细胞淋巴瘤是一组恶性肿瘤的统称，这些恶性 T 淋巴细胞定位于皮肤。在目前 20 种已识别的疾病亚型中，最常见的是蕈样真菌病和赛泽里综合征。体外光化学疗法 (ECP) 是一种免疫调节程序，用光活性剂处理被 pheresed 的血液，于 1988 年获得美国食品和药物管理局批准，作为治疗 CTCL 患者的医疗器械，这是此类患者的众多治疗选择之一。随后，2003 年英国发布了指南，建议对晚期 CTCL 患者使用 ECP，特别是在皮肤靶向治疗方案失败后。目前正在研究 ECP 在 CTCL 早期阶段患者中的应用。本文回顾了 ECP 技术的发展演变，例如，最新一代设备需要的体外血液量低于上一代，从而使更多患者有资格接受该程序。此外，人们对 ECP 在细胞水平上的作用机制有了更多的了解。
