ArticleFrontiers in immunology2026
Extracorporeal photopheresis alone or in combination with ruxolitinib for the treatment of chronic graft-versus-host disease.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Chronic graft-versus-host disease (cGvHD) is a major cause of morbidity after allogeneic hematopoietic stem cell transplantation. Ruxolitinib (RUX) is a standard second-line treatment for steroid-refractory or -dependent cGvHD, while extracorporeal photopheresis (ECP), an autologous cell-based immunomodulatory procedure, is also widely used. However, comparative real-world data on combined immunomodulation with the RUX-ECP combination are scarce. We conducted a retrospective single-center analysis of patients with steroid-refractory or -dependent cGvHD receiving RUX-ECP (n=30) or ECP alone (n=21) between 2012 and 2025. The overall response rate was 77% with RUX-ECP and 52% with ECP (p=0.13), with CR rates of 17% and 10% (p=0.69). RUX-ECP was associated with a significantly shorter time to first response (2.6 vs. 12.3 months, p=0.0249). Organ-specific trends favored RUX-ECP in gastrointestinal, ocular and cutaneous cGvHD, whereas both regimens showed limited activity in pulmonary disease. Overall survival, relapse incidence and non-relapse mortality were comparable. At 12 months, complete steroid discontinuation (69% vs. 10%; p=0.005) and relative corticosteroid reduction were significantly greater with RUX-ECP (88% vs. 30%; p=0.0026). Toxicities of RUX-ECP were manageable and consistent with the known RUX profile, and several patients discontinued therapy after stable responses. Thus, combined immunomodulation with RUX-ECP showed high and fast response rates, a favorable safety profile and substantial steroid-sparing, supporting further evaluation in steroid-refractory or -dependent cGvHD patients.
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