Successful use of miniphotopheresis for the treatment of graft-versus-host disease.

BACKGROUND: Extracorporeal photopheresis (ECP) is an important cell-based therapy for graft-versus-host disease (GVHD); however, the blood volume required per treatment to achieve a clinical response is unknown. STUDY DESIGN AND METHODS: We developed a mini-ECP technique (mini-ECP) using only 100 to 200 mL of whole blood for patients with contraindications for apheresis or low body weight. Sixteen patients (n = 13 acute, n = 3 chronic GVHD) with a median body weight of 19 kg (range, 7-48 kg) received 460 mini-ECP treatments with a median duration of 115 days (range, 49-973 days). RESULTS: Mini-ECP was well tolerated, and acute GVHD resolved completely in nine of 13 patients and partially in two patients but not in two patients. Cutaneous chronic GVHD exhibited a mixed response (one complete, one partial, and one no response). CONCLUSION: These results indicate mini-ECP as a novel and less invasive therapy for patients with GVHD and contraindications for apheresis.