Photopheresis
The Clinical Apheresis Unit provides photopheresis as an outpatient procedure at the Beatson West of Scotland Cancer Centre and for Haematology inpatients at the Queen Elizabeth University Hospital and the Royal Hospital for Children.
The team at the Clinical Apheresis Unit will carry out an assessment before the treatment schedule begins. This visit may include some additional tests where appropriate such as; pulmonary function tests, skin biopsy and medical photographs. These will help us to monitor response to treatment.
Photopheresis is a procedure performed on a cell separator machine.
The machine separates blood into its various components using a centrifuge. When the white cell layer is separate from the rest of the blood this layer, which includes lymphocytes, is collected.
Once collected a light activating drug is added to the cells and then these cells are exposed to UVA light. On completion of the procedure, the cells are infused back to the patient.
Photopheresis is used for a small group of conditions which are related to overactivity of a type of white blood cell called T Lymphocytes.
The 2 main conditions treated have been Sézary Syndrome also known as Cutaneous T-cell Lymphoma and Graft versus Host Disease (GvHD).
A few patients have been treated for Crohns Disease and Nephrogenic Fibrosing Dermopathy (NFD).
A large needle is placed into a large vein in your arm, which allows blood to be drawn into a centrifuge bowl within the cell separator machine where the cells are separated into its different parts.
The machine collects a small portion of the white cells and the other cells are returned to you via the needle in your arm or a 2nd needle in your other arm. When the collection cycle is complete a drug called Methoxsalen is added to the collection bag. This makes the cells sensitive to light. The cells are then passed between 2 ultra violet (UVA) lights much like a sunbed, which causes changes within the cells. The cells are then returned to you. If your veins are not suitable you may need to have a special tube called a central venous catheter inserted into a larger vein after a local or general anaesthetic. Each treatment session will last 2-3 hours.
A trained nurse will care for you during the procedure to ensure your comfort and safety. The photopheresis will be carried out while you rest on a bed or reclining chair.
Generally there are very few side effects and any minor ones can be treated simply and quickly. Potential side effects are; tingling in your lips, nose or fingers or feeling light-headed or faint. Sometimes patients can feel slightly nauseated.
Nursing staff will be with you and will sort any of these issues out promptly. You can help to avoid some of these side effects by eating well and drinking plenty the day before and day of your procedure.
The drug Methoxsalen, which treats your cells, will make you sensitive to sunlight and so more prone to burning. You should wear a high factor sunscreen, sunglasses and a hat when going outside, for 24 hours after completion of your treatment.
You can eat and drink normally during your procedure; some people can feel quite tired for 24 hours afterward.
Treatment schedules vary and this will be discussed with you at your assessment visit.