PHOTOPHERESIS IN THE COMPREHENSIVE TREATMENT OF UROGENITAL REACTIVE ARTHRITIS (REITER’S DISEASE)

The article reports successful use of extracorporeal photochemotherapy (photopheresis) in the comprehensive treatment of 9 patients with urogenital reactive arthritis (Reiter’s disease)

IMMUNOTHERAPEUTIC METHOD FOR TREATMENT OF KAPOSI’S SARCOMA

Aim: To develop a new treatment method for Kaposi’s sarcoma. Materials and methods: 20 patients with Kaposi’s sarcoma (15 patients with idiopathic and 5 patients with immunosuppressive type) underwent clinical and immunological examination before and after translational cell immunotherapy. Method of translational cell immunotherapy involved administration of photosensitizer Ammifurin 0.6  mg/kg 1.5–2  hours before the procedure of intermittent flow separation of mononuclear cells using Haemonetics MCS+ blood cells separator and corresponding protocol. After separation of cells from 2000  ml blood, mean cell count was 6.2±0.8×10⁹ cells per 100  ml plasma. 100  ml of normal saline was added to provide hematocrit value 2% or less. Cell suspension was exposed to UVA-radiation (λ=320–400 nm) using blood irradiator Julia (10–15 ml/min) during 90 minutes. Then, 200 ml of nutrient buffer solution Intersol (Baxter) for long-term storage of platelets was added to cell suspension; reaction mixture was incubated at 37 °С during 18–20 hours under constant stirring in thrombomixer, then re-infused during 30 minutes. Results: Analysis of immunological phenotype of patients with Kaposi’s sarcoma demonstrated alterations predominantly in cell immunity. After the cycle of translational cell therapy, dramatic clinical improvement was observed in all patients. After 1–5  years of follow-up, remission duration was 5 months – 4 years (mean value – 14.8 months). Conclusion: Translational cell immunotherapy produced good clinical effects and slowed down disease progression. Thus, it can be recommended for adjuvant or alternative treatment of Kaposi’s sarcoma

EXTRA-CORPOREAL PHOTOCHEMOTHERAPY IN THE TREATMENT OF LYMPHOMATOID PAPULOSIS AND FOLLICULOTROPIC MYCOSIS FUNGOIDES: CASE REPORTS

Aim: To assess clinical efficacy of extra-corporeal photochemotherapy (EPCT) in the treatment of rare lymphomas  – lymphomatoid papulosis and folliculotropic mycosis fungoides. Materials and methods: This is a presentation of two cases of lymphomatoid papulosis and folliculotropic mycosis fungoides treated with EPCT with duration of follow-up 9 and 12  years. Extracorporeal photochemotherapy involved administration of 8-methoxypsoralen 0.6 mg/kg 1.5–2 hours before the initiation of intermittent flow separation of mononuclear cells using Haemonetics MCS+ blood cells separator and corresponding protocol. Cell suspension was exposed to UVA-radiation (λ=320–400  nm) using blood irradiator Julia (10–15 ml/min) during 30 minutes then re-infused. In total, 4 procedures were conducted every other day. Results: Both patients demonstrated positive effect involving regression of the rashes after 3 EPCT cycles. Subsequently, the patients received maintenance EPCT 2–3 times a year. Conclusion: High clinical efficacy of EPCT was demonstrated in 2  patients with lymphomatoid papulosis and folliculotropic mycosis fungoides after 9 and 12 years of follow-up

CLINICAL EFFICACY OF EXTRA-CORPOREAL PHOTOCHEMOTHERAPY IN SYSTEMIC LUPUS ERYTHEMATOSUS

Aim: To assess clinical efficacy of extracorporeal photochemotherapy in patients with systemic lupus erythematosus (SLE). Materials and methods: 30 SLE patients were thoroughly examined. 16 of them received medical treatment and extracorporeal photochemotherapy (treatment group), 14 patients  – routine therapy only (controls). Extracorporeal photochemotherapy involved administration of 8-methoxypsoralen 0.6 mg/kg 1.5–2 hours before the initiation of intermittent flow separation of mononuclear cells using Haemonetics MCS+ blood cells separator and corresponding protocol. Cell suspension was exposed to UV-radiation (λ=320– 400 nm) using blood irradiator Julia (10–15 ml/min) during 30 minutes then re-infused. In total, 4 procedures were conducted every other day. Results: After 3 courses of extracorporeal photochemotherapy, effect (reduced eruptions) was obtained in 14 patients (46.7%). Then, the patients underwent maintenance photochemotherapy 2–3 times a year. Conclusion: Extracorporeal photochemotherapy was effective in the treatment of SLE. Immunological studies have demonstrated pathogenetic effects of extracorporeal photochemotherapy