Application of Photodynamic Therapy with 5-Aminolevulinic Acid to Extracorporeal Photopheresis in the Treatment of Patients with Chronic Graft-versus-Host Disease: A First-in-Human Study
Open accessAbstract
Extracorporeal photopheresis (ECP), an immunomodulatory therapy for the treatment of chronic graft-versus-host disease (cGvHD), exposes isolated white blood cells to photoactivatable 8-methoxypsoralen (8-MOP) and UVA light to induce the apoptosis of T-cells and, hence, to modulate immune responses. However, 8-MOP-ECP kills diseased and healthy cells with no selectivity and has limited efficacy in many cases. The use of 5-aminolevulinic acid (ALA) and light (ALA-based photodynamic therapy) may be an alternative, as ex vivo investigations show that ALA-ECP kills T-cells from cGvHD patients more selectively and efficiently than those treated with 8-MOP-ECP. The purpose of this phase I-(II) study was to evaluate the safety and tolerability of ALA-ECP in cGvHD patients. The study included 82 treatments in five patients. One patient was discharged due to the progression of the haematological disease. No significant persistent changes in vital signs or laboratory values were detected. In total, 62 adverse events were reported. Two events were severe, 17 were moderate, and 43 were mild symptoms. None of the adverse events evaluated by the internal safety review committee were considered to be likely related to the study medication. The results indicate that ALA-ECP is safe and is mainly tolerated well by cGvHD patients.
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A recent clinical study showed that extracorporeal photopheresis by ALA-PDT was safe and well tolerated in patients with chronic graft-versus-host disease.
“A recent clinical study showed that extracorporeal photopheresis by ALA-PDT was safe and well tolerated in patients with chronic graft-versus-host disease [163].”
From 5-Aminolevulinic Acid as a Theranostic Agent for Tumor Fluorescence Imaging and Photodynamic Therapy (2023) · cites this paper as [163]
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- Authors
- Christensen, E., Foss, O. A., Quist-Paulsen, P., Staur, I., Pettersen, F., Holien, T., Juzenas, P., & Peng, Q.
- Affiliations
- Oslo University Hospital (NO)
- Norwegian University of Science and Technology (NO)
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7030 Trondheim, Norway
- St Olav's University Hospital (NO)
- Corresponding author
- Christensen, Eidi
- Venue
- Pharmaceutics
- Publisher
- MDPI AG
- Published
- 2021-09-26
- Volume
- 13
- Issue
- 10
- Pages
- 1558
- ISSN
- 1999-4923 (ISSN-L)
- PMC
- PMC8538664
- OpenAlex
- W3202019255
- Cited by
- 10
- References
- 36
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 2 · 2022: 3
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Pharmaceutics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- Helse Sør-Øst RHF (2015075,2016092, 2017058,2020069)
- Kreftforeningen (190397)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Photodynamic Therapy Research Studies
- Health Sciences › Medicine › Hematology › Hematopoietic Stem Cell Transplantation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal Health and Biochemistry
- Keywords
- photodynamic therapy, 5-aminolevulinic acid, extracorporeal photopheresis, chronic graft-versus-host disease, 8-methoxypsoralen, T cell apoptosis, immunomodulatory therapy, safety and tolerability, adverse events, first-in-human study
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