Extracorporeal Photopheresis (ECP) Program


At Lurie Children’s we offer extracorporeal photopheresis (ECP) to treat graft-versus-host disease (GVHD) following hematopoietic stem cell transplant and organ rejection after solid organ transplant. ECP is a non-surgical, painless treatment of the blood that alters the patient’s immune system by slowing down certain cells that are often responsible for attacking the body or transplanted organ from within. In this procedure, the patient’s blood is collected slowly and sent to a machine where the white blood cells are separated from the rest of the blood and drawn into a bag. The rest of the blood components are returned to the child. The machine then mixes a medication with the white blood cells that makes them sensitive to ultraviolet (UV) light. The cells are then drawn into a thin plastic chamber with UV light bulbs where they are exposed to light for about 20-30minutes. The cells are then re-infused back into the patient.

Standard treatment of GVHD and organ rejection consists of corticosteroids and other immune suppressing medications. Unfortunately, these treatments greatly increase the risk for infections as well as other complications. ECP may be considered in children with GVHD or rejection after solid organ transplant if medicines like steroids and other immunosuppressants aren’t working well enough. For many patients, ECP is able to slow down and ultimately reverse the negative immune response allowing the patient to heal and potentially lower the doses of other immunosuppressive medications, including steroids, over time.


Who Can Be Treated With ECP?

Lurie Children’s offers ECP for children and young adults who are suffering from graft-versus-host disease (GVHD) or rejection after a solid organ transplant. If a patient has been found to be unresponsive to first line treatment, their physician may recommend them for ECP. ECP can be performed in combination with other treatments.

Lurie Children’s ECP program was founded in 2005; we have performed over 3,000 treatments for patients with GHVD, lung transplant, and heart transplant.

What Does a Patient Need for ECP?

Most patients will need a central line to have ECP performed. In some cases, in older children or adults, treatments can be done using peripheral (arm) IVs that are placed on the day of each treatment. Some patients will need more frequent transfusions of red blood cells and platelets while getting ECP treatments.

What Should I Expect During ECP?

When the patient arrives to the clinic for ECP, labs will be drawn, and the patient will be evaluated to make sure the treatment will be safe to perform. Smaller children may need to have a unit of donor blood added to the tubing of the machine before the treatment starts. When ready, ECP will be performed using the central line or IV through a machine that is sterile. Each treatment takes between 3 and 5 hours. Once the procedure is complete, your nurse will give you instructions of how to keep your skin and eyes healthy from the sun in the 24 hours following your ECP treatment.

This treatment is not painful, and children do not need to be sedated for it. In the beginning, ECP is typically performed on two consecutive days per week for about 12 weeks. It is then spread out to be every other week, and then monthly. Patients will usually undergo ECP treatments for 4–6 months depending on their response to the therapy.

Over time, it is expected that your child’s cells will be less reactive against the body in the case of GVHD and against the solid organ that was transplanted in the case of a solid organ transplant. This will hopefully stop the progression of damage and help reverse some of the complications associated with the GVHD or organ rejection.

Our Specialists

The program is led by Jennifer Schneiderman, MD, MS, Hematology, Oncology, Neuro-Oncology & Stem Cell Transplantation, Associate Professor of Pediatrics, Northwestern University Feinberg School of Medicine. Dr. Schneiderman and our transplant team have published numerous papers and given talks about the use of ECP in children around the world. She is on the Board of Directors for the American Society for Apheresis and was the Chair of the ECP Subcommittee for several years, which does research in the field of ECP.

The nursing team is made up of specialized RNs who are also experts in performing these treatments. 

Appointments

If you’d like to request an appointment with one of our specialists, call 312.227.9756.

Philanthropy

Your support is vital in helping us continue to make a difference in the lives of patients and families. Lurie Children’s relies on philanthropic funding to enhance its programs, services and research for children. To learn more, please e-mail the Ann & Robert H. Lurie Children’s Hospital of Chicago Foundation at foundation@luriechildrens.org or call 312.227.7500.

Conditions We Treat