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Extracorporeal photopheresis (ECP) is an immunomodulatory therapeutic procedure which includes leukapheresis of peripheral blood, then separation of the buffy coat, and finally the irradiation of cells before re-infusion. ECP is commonly used either in combination with infliximab or monotherapy as a second-line therapy for patients with graft-versus-host disease (GvHD) who are dependent or refractory to steroids.
Pastora Iniesta from the Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, Murcia, Spain, and colleagues assumed that CD56bright NK cells may increase in patients with GvHD who respond to ECP therapy and may correlate with response rates. The researchers prospectively studied blood subsets during ECP treatment.
In conclusion, this study showed elevated levels of CD56bright NK cells after ECP therapy. The authors stated that “an early increase of CD56bright NK cells may be involved in the complex interplay of immunologic cells in exerting tolerance induced by ECP, both in aGvHD and cGvHD. This is also supported by the ability of the CD56bright to CD56dim NK cells ratio to predict for CR to the phototherapy.” These findings require independent validation including further exploring approaches for priming CD56bright NK cell expansion during ECP and revisiting the underpinning cellular mechanisms of ECP that could induce cell expansion.
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