Gollnick H P, Owsianowski M, Ramaker J, Chun S C, Orfanos C E
Department of Dermatology, University Medical Center Steglitz, Free University of Berlin, Germany.
Recent Results Cancer Res. 1995;139:409-15. doi: 10.1007/978-3-642-78771-3_32.
Extracorporeal photochemotherapy (extracorporeal photopheresis, ECP) is going to become a new alternative in the treatment of cutaneous T cell lymphomas (CTCL), autoimmune disorders, and transplant rejections. After the first promising results in the treatment of CTCL reported in 1987 by Edelson et al. increasing numbers of CTCL patients in a growing number of ECP centers throughout the United States, Europe, and Japan have been successfully treated. Today, it seems that in particular Sézary's syndrome and the erythrodermic variant of mycosis fungoides (MF) respond very well to ECP. Compared to historical controls of MF with lymph node involvement, the median survival of the ECP-treated patients increased from 30 months to up to 60 months. It is our experience that the tumor stage of MF, however, cannot be treated with ECP alone, but is successfully controlled by combination regimens, for example with recombinant interferon alpha. CTCL patients heavily pretreated by polychemotherapy and severe endogenous or iatrogenic immunsuppression do not respond sufficiently and are not good candidates for ECP. The adverse reactions under ECP are well controlled and very low in number. In particular, general immunosuppression by ECP has not been reported so far.
体外光化学疗法（体外光分离置换法，ECP）即将成为治疗皮肤T细胞淋巴瘤（CTCL）、自身免疫性疾病和移植排斥反应的一种新选择。1987年埃德尔森等人报道了ECP治疗CTCL取得的首个令人鼓舞的结果后，美国、欧洲和日本越来越多的ECP中心有越来越多的CTCL患者得到了成功治疗。如今，似乎特别是 Sézary 综合征和蕈样肉芽肿（MF）的红皮病型对ECP反应非常良好。与有淋巴结受累的MF历史对照相比，接受ECP治疗的患者的中位生存期从30个月增加到了60个月。然而，根据我们的经验，MF的肿瘤期不能仅用ECP治疗，而是通过联合方案（例如与重组干扰素α联合）成功控制。经过多药化疗以及严重的内源性或医源性免疫抑制的CTCL患者反应不佳，不是ECP的理想候选者。ECP的不良反应得到很好的控制，数量非常少。特别是，目前尚未报道ECP会导致全身免疫抑制。
