Servizio di Immunoematologia e Medicina Trasfusionale, A.O. San Camillo-Forlanini, Roma, Italy; Università La Sapienza, Roma, Italy; Servizio Trasfusionale, UOS Aferesi e Nuove Tecnologie Trasfusionali, A.O. San Gerardo, Monza, Italy; Unità di Ematologia, Divisione di Medicina Interna, Ospedale C. Massaia, Asti, Italy; Clinica di Oncoematologia Pediatrica, Università di Padova, Padova, Italy; Servizio di Immunoematologia e Trasfusionale, Unità di Terapia Cellulare, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy; UO Immunoematologia, A. O. Universitaria Pisana, Pisa, Italy; Divisione Ematologia e Trapianto di Midollo Osseo, Ospedale San Martino, Genova, Italy; Dipartimento of Oncologia/Ematologia Pediatrica, IRCCS Ospedale Pediatrico Bambino Gesù, Pavia, Italy; Università di Pavia, Pavia, Italy; Centro Trasfusionale, Ospedale San Martino, Genova, Italy; UO Ematologia, A.O. Careggi and Università di Firenze, Firenze, Italy.
Transfusion. 2013 Oct;53(10):2340-52. doi: 10.1111/trf.12059. Epub 2013 Jan 10.
Extracorporeal photopheresis (ECP) is an effective treatment for both acute and chronic graft-versus-host disease (GVHD) in children and adults. Despite the large use of this treatment, a large heterogeneity in current application of ECP has been reported so far and recent evidence brought novel issues into some specific topics. Consensus-based recommendations ameliorate the appropriateness in daily clinical practice and, in turn, optimize the use of health care resources.
Two Italian scientific societies, the Italian Society of Hemapheresis and Cell Manipulation (SIdEM) and the Italian Group for Bone Marrow Transplantation (GITMO), joined to develop and disseminate recommendations on appropriate application of ECP treatment in patients with GVHD. Accordingly, SIdEM and GITMO named an expert panel that first selected 16 questions that were considered relevant for clinical practice: the questions were subsequently addressed through a revision of the available literature and in consensus meetings. The whole group discussed the proposed recommendations according to the nominal group technique.
The above-described approach in turn allowed the panel to agree on 47 practice recommendations. SIdEM and GITMO will disseminate such recommendations to the national transplant centers.
In conclusion, SIdEM and GITMO have made a scientific effort to provide a useful tool to physicians involved in the field, thus supporting daily clinical practice, as well as strategic decisions in the setting of ECP treatment of GVHD.
体外光分离术（ECP）是治疗儿童和成人急性和慢性移植物抗宿主病（GVHD）的有效方法。尽管这种治疗方法的应用非常广泛，但迄今为止，ECP 的应用存在很大的异质性，最近的证据也为一些特定的主题带来了新的问题。基于共识的建议可以改善日常临床实践中的适当性，并优化医疗资源的利用。
两个意大利科学协会，即意大利血液分离和细胞操作学会（SIdEM）和意大利骨髓移植组（GITMO），联手制定并传播关于 ECP 治疗在 GVHD 患者中的适当应用的建议。因此，SIdEM 和 GITMO 任命了一个专家小组，该小组首先选择了 16 个被认为与临床实践相关的问题：这些问题随后通过审查现有文献和共识会议来解决。整个小组根据名义小组技术讨论了拟议的建议。
上述方法使小组能够就 47 条实践建议达成一致。SIdEM 和 GITMO 将向全国移植中心传播这些建议。
总之，SIdEM 和 GITMO 进行了科学努力，为参与该领域的医生提供了一个有用的工具，从而支持日常临床实践，以及 ECP 治疗 GVHD 时的战略决策。
