Immuno-regulatory Profiling of T Cells in GVHD Treated With Extracorporeal Photopheresis
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 2/24/2019 |
| Start Date: | August 26, 2014 |
| End Date: | August 30, 2019 |
Immuno-regulatory Profiling of T Cells in Patients With Graft Versus Host Disease Treated With Extracorporeal Photopheresis
Extracorporeal Photopheresis (ECP) has been used as one of the treatments for graft versus
host disease (GVHD). Responses were observed in skin, liver, GI tract, mouth, eye and lung.
ECP does not cause immune suppression and therefore less risk of infection or relapse of
malignancy. However, the exact mechanism of action of this expensive procedure is not fully
understood and no predictors of response to ECP are known so far. This reflects the need for
a better understanding of GVHD and its response to ECP. Blood samples from 15 patients who
receive ECP as part of the treatment of GVHD at our institution will be collected. Samples
will be analyzed using flow cytometer
host disease (GVHD). Responses were observed in skin, liver, GI tract, mouth, eye and lung.
ECP does not cause immune suppression and therefore less risk of infection or relapse of
malignancy. However, the exact mechanism of action of this expensive procedure is not fully
understood and no predictors of response to ECP are known so far. This reflects the need for
a better understanding of GVHD and its response to ECP. Blood samples from 15 patients who
receive ECP as part of the treatment of GVHD at our institution will be collected. Samples
will be analyzed using flow cytometer
Inclusion Criteria:
1. Patients who are recipients of allogeneic stem cell grafts.
2. Patients with the diagnosis of GVHD according to established criteria and physician
decides to treat using ECP
3. Patient must have 100% chimerism with the donor
4. No recent donor lymphocyte infusion.
5. Patients must be able to sustain a platelet count and a hematocrit > 20,000/mL and >
27% respectively, with or without transfusions.
6. The absolute WBC must be >1500/mL
7. Patient must be willing to comply with all study procedures.
Exclusion criteria:
1. Patients who are unable to tolerate the volume shifts associated with ECP treatment
due to the presence of any of the following conditions: uncompensated congestive heart
failure, pulmonary edema, severe asthma or chronic obstructive pulmonary disease,
hepatorenal syndrome.
2. Active bleeding.
3. International normalized ration (INR) >2.
4. Patients with known hypersensitivity or allergy to psoralen.
5. Patients with known hypersensitivity or allergy to both citrate and heparin.
6. Patients with co-existing photosensitive disease (e.g. porphyria, systemic lupus
erythematosus, albinism) or coagulation disorders.
7. Active, uncontrolled infection
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