Description of Medical ServiceExtracorporeal photopheresis (ECP) service is indicated for the management of steroids-refractory acute and chronic GVHD and CTCL. It is a cell-based immunomodulatory therapy performed via intravenous access, comprising three stages: leukapheresis, photoactivation and reinfusion. Blood is passed through multiple cycles of leukapheresis. At the end of the each leukapheresis cycle, the red blood cells and plasma are returned to the patient. Only a small percentage (approximately 10%) of leukocytes is collected from peripheral blood. These white blood cells are incubated with a photosensitising agent, methoxsalen (UVADEX®), and are then exposed to ultraviolet A (UVA) irradiation, after which the treated cells are reinfused back to the patient.
Description of Medical ConditionGraft-versus-host disease Graft-versus-host disease (GVHD) is an immune-mediated disease resulting from a complex interaction between donor and recipient adaptive immunity. It is a frequent complication of allogeneic bone marrow transplants or solid organ transplants.
Reason for ApplicationNew MBS item
Medical Service TypeTherapeutic
Previous Application NumberNot Applicable
PICO ConfirmationTwo protocols are being developed for this MSAC application:
1) Extracoporeal photopheresis for treatment of acute and chronic graft-versus-host disease:
1420 GVHD - Consultation Protocol (PDF 1774 KB)
1420 GVHD - Consultation Protocol (Word 506 KB)
2) Extracoporeal photopheresis for treatment of cutaneous T-cell lymphoma:
1420 CTCL - Consultation Protocol (PDF 2125 KB)
1420 CTCL - Consultation Protocol (Word 897 KB)