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Looking to the future of ECP for the management of GvHD
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On November 29, 2022, the GvHD Hub held a virtual symposium on the role of extracorporeal photopheresis (ECP) in the management of graft-versus-host disease (GvHD).
Here, we share the third presentation, given by Professor Daniel Wolff, University Hospital Regensburg, Regensburg, D,E which looked at the future use of ECP in patients with GvHD.
In this presentation, Professor Wolff discusses the current status of treatment in GvHD and assesses what is in store for the treatment of acute GvHD (aGvHD) and chronic GvHD (cGvHD) with ECP. Professor Wolff outlines methods to explore patient biological profiles to establish predictive biomarkers and discusses urgent questions for future research into ECP (Figure 1).
Figure 1. Urgent questions for future research into ECP*
ECP, extracorporeal photopheresis; IL, interleukin.
*Data from ClinicalTrials.gov1–2; Belizaire, et al.3; and Maas-Bauer, et al.4; and Zeiser, et al.5
Watch or download the presentation to learn more about the future of ECP, including:
- The current status of aGvHD treatment (00:17; slide 4)
- The current status of cGvHD treatment (01:55; slide 5)
- The outlook for the treatment of aGvHD (03:19; slide 6)
- The outlook for the treatment of cGvHD (05:48; slide 7)
- The outlook for the future of ECP (07:26; slides 8−9)
Key points
- aGvHD and cGvHD both currently have a poor prognosis, with high rates of long-term treatment-related mortality.
- In aGvHD, there is ongoing research into risk-adapted first-line treatment with upfront ECP and steroids for high-risk patients.
- ECP may be an option for patients with aGvHD or cGvHD who do not respond to ruxolitinib or ECP may be used in combination with other immunosuppressants.
- ECP may be appropriate for patients at high risk of infectious or cytopenic complications, which is a contraindication for the use of ruxolitinib.
- Further research into patients’ biological profiles and response to treatment may help to develop predictive biomarkers for ECP.
This independent educational activity was supported by Mallinckrodt Pharmaceuticals. All content was developed independently by the faculty. The funder was allowed no influence on the content of this activity.
ClinicalTrials.gov. Extracorporal photopheresis with UVADEX plus standard steroid treatment for high risk acute graft-versus-host disease. https://clinicaltrials.gov/ct2/show/NCT04291261.
ClinicalTrials.gov. Biomarkers in acute graft-versus-host disease and extracorporeal photopheresis added to investigator chosen therapies of steroid refractory acute GVHD. https://clinicaltrials.gov/ct2/show/NCT02322190.
- Belizaire R, Kim HT, Poryanda SJ, et al. Efficacy and immunologic effects of extracorporeal photopheresis plus interleukin-2 in chronic graft-versus-host disease. Blood Adv. 2019;3(7):969-979. DOI: 10.1182/bloodadvances.2018029124
Maas-Bauer K, Kiote-Schmidt C, Bertz H, et al. Ruxolitinib-ECP combination treatment for refractory severe chronic graft-versus-host disease. Bone Marrow Transplant. 2021;56(4):909-916. DOI: 10.1038/s41409-020-01122-8
Zeiser R, Polverelli N, Ram R, et al. N Engl J Med. Ruxolotinib for glucocorticoid-refractory chronic graft-verus-host disease. 2021;385(3):228-238. DOI: 10.1056/NEJMoa2033122
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