Extracorporeal photopheresis
Extracorporeal photopheresis in low-weight children
We offer extracorporeal photopheresis (ECP) to treat graft-versus-host disease (GVHD) in children, a complication after a bone marrow transplant that may be life threatening.
The biggest potential benefit of ECP is that children can avoid taking drugs like steroids that suppress the immune system to treat GVHD. These drugs can be tapered off over time and stopped once the disease is brought under control by ECP. The problem with steroids and similar drugs is that they place patients at high risk of infection and can eventually harm various organs. ECP can be a safe and effective alternative.
Our team has developed a way to use ECP for children weighing as little as 15 kg (33 lb). Children's Memorial is the only hospital in the U.S. to perform ECP in children who weigh less than 40 kg (88 lb) using a “closed system,” which means that the entire process stays within the machine, making it safer and faster.
What happens during extracorporeal photopheresis?
A measure of the child's blood is drawn using a sterile, closed system ECP machine, which separates the white blood cells and treats them with medication followed by ultraviolet light. The treated blood then returns to the patient and modifies the immune system over time to reduce GVHD.
Patients weighing less than 40 kg must get fluids through an IV to replace lost fluids when their blood is drawn. We give these patients a calculated dose of fluid (normal saline or 5% albumin) before and during ECP as needed. Adults or children weighing over 40 kg generally do not need extra fluids because the blood drawn during ECP is a smaller percentage of the total blood volume in their body.
How long does extracorporeal photopheresis take?
The drawn blood remains out of the body for up to 25 minutes per cycle. Usually we do three cycles per treatment day and the entire process takes about four hours.
Patients may need to continue ECP treatments for a few years. Your child's doctor will let you know how long and how often ECP will be needed to treat your child's condition.
Does my child qualify for extracorporeal photopheresis?
Children with GVHD that has not responded adequately to immune suppression with steroids and other medications may be considered for this therapy.
Our expertise with extracorporeal photopheresis in low-weight children
Jennifer Schneiderman, MD, MS, and our stem cell transplantation team recently published their experience using ECP with 11 patients over a five-year period in the Journal of Clinical Apheresis.
Contact us
For more information, please contact Dr. Schneiderman at 773.880.4562.