Marques Marisa B, Adamski Jill
Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama.
J Clin Apher. 2014 Aug;29(4):228-34. doi: 10.1002/jca.21333. Epub 2014 May 14.
Extracorporeal photopheresis (ECP) has had a major impact in the treatment of various conditions in the past 25 years. Although it was initially developed for the treatment of patients with resistant cutaneous T cell lymphoma (CTCL), this therapy was later used to treat recipients of solid organs and stem cell transplants with rejection or graft-versus-host disease (GVHD), respectively. A significant number of patients with CTCL can achieve long term remission with ECP therapy. Those patients with heart or lung transplants may experience fewer or shorter rejection episodes following ECP. Furthermore, patients that respond to ECP can generally reduce the dose of immunosuppression medication, thus minimizing the morbidity caused by drugs such as corticosteroids and calcineurin inhibitors. While the exact mechanism of action of ECP is not well-understood, evidence suggests that reinfusion of the patient's apoptotic white blood cells, the ultimate product of ECP, promotes immunomodulatory events that are beneficial in patients with CTCL, transplant rejection, GVHD, and possibly other inflammatory conditions.
在过去25年里，体外光化学疗法（ECP）对多种病症的治疗产生了重大影响。尽管它最初是为治疗难治性皮肤T细胞淋巴瘤（CTCL）患者而开发的，但这种疗法后来分别用于治疗患有排斥反应或移植物抗宿主病（GVHD）的实体器官移植受者和干细胞移植受者。大量CTCL患者通过ECP治疗可实现长期缓解。接受心脏或肺移植的患者在接受ECP治疗后可能经历更少或更短的排斥反应发作。此外，对ECP有反应的患者通常可以减少免疫抑制药物的剂量，从而将皮质类固醇和钙调神经磷酸酶抑制剂等药物引起的发病率降至最低。虽然ECP的确切作用机制尚不完全清楚，但有证据表明，将患者凋亡的白细胞（ECP的最终产物）回输，可促进免疫调节事件，这对CTCL、移植排斥、GVHD以及可能的其他炎症性病症患者有益。
