According to the result of a multisite retrospective cohort study presented at the BMT Tandem Meetings, extracorporeal photopheresis reportedly stabilized forced expiratory volume in the first breath, therefore prolonging survival in patients with bronchiolitis obliterans syndrome (BOS) post-transplantation. Administration of immunosuppressive therapies with steroids and calcineurin inhibitors is employed for slowing BOS progression. Apart from steroids, there is currently no standard treatment option available. Owing to suboptimal responses to conventional immunosuppressive therapies, there are efforts undertaken to explore the use of extracorporeal photopheresis (ECP) as alternative immunomodulatory treatment. However, the data reporting the efficacy of ECP is limited to a few cases. Moreover, ECP therapy is very costly, more frequent, and logistically challenging.
One peculiar aspect of ECP is its capability to augment to effects namely, activation of the immune system and down-regulation of T-lymphocyte activity. This effect of ECP is reported to have a potential in allogeneic hematopoietic stem cell transplantation patients as this therapy does not cause generalized immunosuppression and therefore controls the risk of developing disease relapse and infection complication. Bronchiolitis obliterans syndrome reportedly affects 10% of patients after allogeneic hematopoietic stem cell transplantations within the first two years.
More effective and safer treatment offered by the new photopheresis systems is the key driver of photopheresis products market. The standard pharmacotherapy with steroids and immunosuppressants has reportedly demonstrated several undesirable side effects. Moving from this methods to effective ECP that demonstrates safer and equally efficacious outcomes, the demand for ECP products will soar in the future. Governments worldwide are also been promoting the adoption of ECP through reimbursements and training programmes. By far, high cost and logistical challenges of ECP devices have been a significant challenge to the swift adoption of ECP in the mainstream. However, hospitals are increasingly considering the transition from multi-step procedures to fully integrated photopheresis methods where cost is a significant concern. Hospitals are adopting such fully integrated systems for not just saving time and procedure cost, but also overall work efficiencies attained through allowing more patient treatments per year.