ECP-based combinations for steroid-refractory/dependent acute and chronic GvHD

During the 52nd Annual Meeting of the European Society for Blood and Marrow Transplantation, March 22–25, 2026, Madrid, ES, Simon Bulley presented an analysis of pharmacy and medical records evaluating extracorporeal photopheresis (ECP) + ruxolitinib for steroid-refractory/dependent acute graft-versus-host disease (aGvHD) (n = 12) and ECP + belumosudil vs belumosudil alone for steroid-refractory/dependent chronic graft-versus-host disease (cGvHD) (n = 17). For aGvHD, outcomes assessed were response rate and overall survival (OS); for cGvHD, outcomes were successful time on therapy and corticosteroid weaning.

Key data: Among patients with aGvHD treated with ECP + ruxolitinib, the complete or partial response rate was 83.3%, corticosteroids were discontinued in 75% of patients, and OS was 66% at 8 months’ median follow-up. Among patients with cGvHD, despite a higher proportion of severe disease in the ECP + belumosudil group vs the belumosudil-only group (75.0% vs 44.4%), median successful time on therapy was longer (13 vs 4 months), corticosteroid weaning to a physiological dose was more frequent (60.0% vs 25.0%), and treatment discontinuation was less common (50.0% vs 66.7%). Toxicity-related treatment discontinuation was 0% in the ECP + belumosudil group vs 33.3% with belumosudil alone.

Key learning: ECP-based combinations were associated with encouraging signs of efficacy and safety in both steroid refractory/dependent aGvHD and cGvHD, and may facilitate steroid tapering, warranting further evaluation in prospective studies.