At Lurie Children’s 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, which 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. Children with GVHD that has not responded adequately to immune suppression with steroids and other medications may be considered for this therapy.
What to Expect
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 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.
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.
If you’d like to request an appointment with one of our specialists, call 312.227.9756.
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