Photopheresis

Photopheresis is a treatment that strengthens your body’s immune response to cutaneous T cell lymphoma (CTCL), a rare blood cancer that causes itchy, dry skin and rashes. The procedure treats your white blood cells with a drug and ultraviolet light to boost your body’s ability to fight the disease and relieve skin symptoms. Also known as extracorporeal photopheresis (ECP), this therapy can treat other conditions too.

Penn Medicine was one of the first centers to offer photopheresis in the United States, and our highly trained dermatologists and nurses have deep experience performing this procedure. We create a treatment plan that includes a series of photopheresis sessions to improve your symptoms. It may take a few months or longer to get the full benefits of the therapy, but many people see significant improvements in their skin.

Photopheresis may be recommended if other treatments for cutaneous T cell lymphoma haven’t worked or if you have an advanced form of the disease. It’s often used to treat the two most common subtypes of CTCL—Sézary syndrome and mycosis fungoides.

Your health care team might also recommend photopheresis if you have other conditions that affect your skin, like eczema or psoriasis. It can also treat graft-versus-host disease, organ transplant rejection, Crohn’s disease, and type 1 diabetes.

Your health care team will give you instructions on what to do to prepare for ECP treatment. Drink plenty of water and avoid caffeine and alcohol a couple of days before your procedure. Also avoid eating high-fat foods, like fried foods.

During the procedure:

• You’ll recline in a chair or bed and be given an intravenous (IV) line through a vein in your arm or chest.
• A small amount of your blood moves out of your vein and into a machine where the white blood cells are separated out.
• The rest of your blood is returned to your body while the extracted white blood cells are treated with medication.
• These white blood cells are exposed to ultraviolet light, which activates the medication and changes how the cells function.
• The treated white blood cells are returned to your body through your vein and the IV is removed.

Photopheresis will take a few hours, and you can go home afterward. You might have two procedures over two days and repeat the cycle every two to five weeks until your symptoms improve.

You might have changes in your blood pressure, which can make you feel dizzy, cold, or nauseous during or after photopheresis treatment. These side effects can be treated by your health care team. It’s also common to feel tired after the procedure, and you might develop a fever, which you can treat with over-the-counter medication.

When medication is added to your white blood cells during photopheresis, it makes you more sensitive to sunlight, which can lead to sunburn and eye problems. During the first 24 hours after your procedure, avoid direct and indirect sun exposure. Cover your skin, wear sunscreen with SPF 30, and use sunglasses with 100 percent UV protection that wrap around your temples. Take these precautions even when you’re inside, since sunlight coming through a window can cause damage.

Talk to your doctor if you’re concerned about any potential complications of photopheresis therapy.

With one of the oldest photopheresis programs in the nation, Penn Medicine has performed several thousands of these procedures. Our researchers have also studied photopheresis for decades, giving our team extensive knowledge and experience to produce the best results for your symptoms.

Treatment strategies are created for your individual needs with an initial plan that evolves in stages. Over time, your care plan may be adjusted so that you get the most benefit from the therapy, whether you have cutaneous T cell lymphoma, psoriasis, eczema, graft-versus-host disease, or another condition. Enhancing the function of your white blood cells through photopheresis can help you reach your treatment goals to clear your skin and reduce other symptoms.