European dermatology forum - updated guidelines on the use of extracorporeal photopheresis 2020 - part 1

R Knobler; P Arenberger; A Arun; C Assaf; M Bagot; G Berlin; A Bohbot; P Calzavara-Pinton; F Child; A Cho; L E French; A R Gennery; R Gniadecki; H P M Gollnick; E Guenova; P Jaksch; C Jantschitsch; C Klemke; J Ludvigsson; E Papadavid; J Scarisbrick; T Schwarz; R Stadler; P Wolf; J Zic; C Zouboulis; A Zuckermann; H Greinix

doi:10.1111/jdv.16890

European dermatology forum - updated guidelines on the use of extracorporeal photopheresis 2020 - part 1

J Eur Acad Dermatol Venereol. 2020 Dec;34(12):2693-2716. doi: 10.1111/jdv.16890. Epub 2020 Oct 6.

Authors

R Knobler¹, P Arenberger², A Arun³, C Assaf⁴, M Bagot⁵, G Berlin^{6

7}, A Bohbot⁸, P Calzavara-Pinton⁹, F Child¹⁰, A Cho¹, L E French¹¹, A R Gennery¹², R Gniadecki¹³, H P M Gollnick¹⁴, E Guenova^{15

16}, P Jaksch¹⁷, C Jantschitsch¹, C Klemke¹⁸, J Ludvigsson¹⁹, E Papadavid²⁰, J Scarisbrick²¹, T Schwarz²², R Stadler²³, P Wolf²⁴, J Zic²⁵, C Zouboulis²⁶, A Zuckermann²⁷, H Greinix²⁸

Affiliations

¹ Department of Dermatology, Medical University of Vienna, Vienna, Austria.
² Third Faculty of Medicine, Charles University, Prague, Czech Republic.
³ FRCPath, The Rotherham NHA Foundation Trust, Rotherham, UK.
⁴ Department of Dermatology and Venerology, Helios Klinikum Krefeld, Krefeld, Germany.
⁵ Hospital Saint Louis, Université de Paris, Paris, France.
⁶ Department of Clinical Immunology and Transfusion Medicine, Linköping University, Linköping, Sweden.
⁷ Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
⁸ Onco-Hematology Department, Hautepierre Hospital, Strasbourg, France.
⁹ Dermatology Department, University of Brescia Italy, Brescia, Italy.
¹⁰ FRCP, St John's Institution of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
¹¹ Department of Dermatology, University Hospital, München, Germany.
¹² Translational and Clinical Research Institute, Newcastle University Great North Children's Hospital Newcastle upon Tyne, Newcastle University, Newcastle upon Tyne, UK.
¹³ Division of Dermatology, University of Alberta, Edmonton, AB, Canada.
¹⁴ Dept. Dermatology & Venereology, Otto-von-Guericke University, Magdeburg, Germany.
¹⁵ Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
¹⁶ Department of Dermatology, Lausanne University Hospital CHUV, Lausanne, Switzerland.
¹⁷ Department of Thoracic Surgery, Medical University Vienna, Vienna, Austria.
¹⁸ Hautklinik Städtisches Klinikum Karlsruhe, Karlsruhe, Germany.
¹⁹ Crown Princess Victoria Children's Hospital and Division of Pediatrics, Department of Biomedical and Clinical Sciences, University Hospital, Linköping University, Linköping, Sweden.
²⁰ National and Kapodistrian University of Athens, Athens, Greece.
²¹ University Hospital Birmingham, Birmingham, UK.
²² Department of Dermatology, University Clinics Schleswig-Holstein, Kiel, Germany.
²³ University Clinic for Dermatology Johannes Wesling Medical Centre, UKRUB, University of Bochum, Minden, Germany.
²⁴ Department of Dermatology, Medical University of Graz, Graz, Austria.
²⁵ Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA.
²⁶ Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany.
²⁷ Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
²⁸ Division of Haematology, LKH-Univ. Klinikum Graz, Medical University of Graz, Graz, Austria.

Abstract

Background: Following the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma published in 1983, this technology has received continued use and further recognition for additional earlier as well as refractory forms. After the publication of the first guidelines for this technology in the JEADV in 2014, this technology has maintained additional promise in the treatment of other severe and refractory conditions in a multi-disciplinary setting. It has confirmed recognition in well-known documented conditions such as graft-versus-host disease after allogeneic bone marrow transplantation, systemic sclerosis, solid organ transplant rejection including lung, heart and liver and to a lesser extent inflammatory bowel disease.

Materials and methods: In order to further provide recognized expert practical guidelines for the use of this technology for all indications, the European Dermatology Forum (EDF) again proceeded to address these questions in the hands of the recognized experts within and outside the field of dermatology. This was done using the recognized and approved guidelines of EDF for this task. All authors had the opportunity to review each contribution as it was added.

Results and conclusion: These updated 2020 guidelines provide at present the most comprehensive available expert recommendations for the use of extracorporeal photopheresis based on the available published literature and expert consensus opinion. The guidelines are divided in two parts: PART I covers cutaneous T-cell lymphoma, chronic graft-versus-host disease and acute graft-versus-host disease while PART II will cover scleroderma, solid organ transplantation, Crohn's disease, use of ECP in paediatrics practice, atopic dermatitis, type 1 diabetes, pemphigus, epidermolysis bullosa acquisita and erosive oral lichen planus.

MeSH terms

Child
Dermatology*
Graft vs Host Disease* / prevention & control
Humans
Lymphoma, T-Cell, Cutaneous* / therapy
Photopheresis*
Skin Neoplasms*