Extracorporeal Photopheresis (ECP), also known as Photoimmune therapy, is an Apheresis procedure used to treat symptoms or conditions related to Cutaneous T Cell Lymphoma, graft versus host disease (GVHD), solid organ transplant rejection and some autoimmune disorders. The goal of the treatment is to alter your immune system, which may improve your symptoms or help control your rejection. The procedure is done using a special machine made specifically for Photopheresis.The word Apheresis means to separate. During the procedure, white blood cells are separated from your whole blood. Once separated, the drug Uvadex (Methoxsalen) is added to the cells. The medicated cells are then exposed to Ultraviolet A (UVA) Light. This process is called photoactivation. Once the photoactivation is done, the cells are returned to you. The Apheresis doctor together with your doctor, establish a plan for the number and frequency of your procedures.
About Your Visit
If you are receiving outpatient treatment, you will register in Outpatient Admitting located in the hospital lobby. Please arrive a few minutes before your scheduled appointment. You will be given directions to Apheresis. When you arrive in our unit, our nursing staff will get you ready and make you comfortable before starting with the procedure. A physician will get your medical history and do a physical. They will discuss the procedure with you and answer any questions you may have. You will then be asked to sign a paper giving permission to do the procedure.
Getting StartedIn order to perform your procedure, we need to be able to draw your blood and return it to you. This can be done in different ways. One way is to place a needle in one of your arms to draw the blood into the machine and another smaller needle in your other arm to return the blood back to you. You will need to keep your "draw" arm straight during the entire procedure. If this method is not practical, or if you will need several procedures, a special type of long-term catheter may be placed into a vein in your chest. It will be inserted in a radiology department and will allow you to get the number of procedures you need more comfortably. This catheter will stay in you for the duration of your photopheresis therapy and your physician will discuss these options with you before your first treatment.
What You May Feel
Photopheresis is a painless procedure. Experiences differ, but some symptoms may occur:
- Numbness or tingling around the mouth, nose, hands, fingers, feet, toes
- A "vibrating" sensation or feeling cold
- Feeling dizzy or light-headed
Also, a few patients may experience a slight drop in blood pressure during the procedure. Low blood ressure can be treated easily with intravenous (IV) fluids if needed.A nurse will be with you at all times and will watch for any symptoms during the procedure. A physician will be available if needed. (You will be asked frequently if you are feeling different in any way.) This procedure can last anywhere from 1½ to 3 hours.
What You May Feel After
Your skin and eyes will be very sensitive to sunlight. You must avoid sunlight for at least 24 hours after each procedure, even indirect sun. You will be instructed to wear sunscreen with at least SPF 15, to wear a hat and protective sunglasses (that wrap around the sides of your eyes). You may also notice a flushing or redness of your skin, a slight temperature increase, and feel fatigued after your procedure.
Frequently Asked Questions
May I eat and drink before or during the procedure?
Should I take all my regular medicines before my procedure?
Will my blood touch the machine?
How will I feel after the procedure?
Will I be able to contact someone from Apheresis if I have a question or problem after the procedure?
Yes, we have a nurse and a doctor on call for our service 24 hours a day, 7 days a week. We will explain how to contact them prior to your discharge from our area.
Photopheresis is something that is unfamiliar to many. We realize that you may be anxious the first time you have the procedure. We hope the information we have given you will make you less anxious, and will answer some of the questions you may have.
Please bring a complete list of your medications with you to each of your visits.
For More Information
We want to answer all questions to your satisfaction. If we can be of further assistance, please do not hesitate to contact us:
10I East Tower, Room 10409
750 East Adams Street
Syracuse, New York 13210
Phone: 315 464-9024
Fax: 315 464-9021
Office Hours: Mon-Fri: 7:00 am - 4:30 pm
Emergency Services please call the hospital operator at 315 464-5540. Ask for the nurse on call for apheresis.
Reference: McLeod, B. C., Szczepiorkowski, Z. M., Weistein, R., Winters, J. L. eds. Apheresis: principles and Practice, 3rd edition. Bethesda, MD: AABB Press, 2010. Chapter 28 pp. 615-634.