Your body's immune system is an amazing defense system. But sometimes this system can function a little differently. Sometimes it can become overactive and harm our own body, or sometimes it needs help fighting off enemies like cancer cells. In such cases, we are talking about a special treatment that helps our immune system and controls its activity. That is photopheresis.
Simply put, what is photopheresis?
Photopheresis is a treatment that uses light to change the function of your white blood cells, called lymphocytes. These cells, called lymphocytes, are the main soldiers of our immune system. They are the ones who destroy things like cancer cells, bacteria, and viruses. So, if there is a problem with these lymphocytes, photopheresis treatment is very useful.
Think of it this way. They take some of your blood, put it in a machine, and separate out only the white blood cells called lymphocytes. Then, they mix it with a special drug and expose it to UV light, which changes the way those cells function. Finally, these treated cells are put back into your body along with the rest of your blood.
Through this method, we can strengthen our immune system, or control it if it is acting in an unwanted way. In other words, this treatment has the ability to 'turn the switch on and off' the immune system as needed.
What conditions is this treatment used for?
Photopheresis is a type of immunotherapy. That is, it is a method of treating diseases by using our own immune system. There are several main uses for it.
| Medical condition | A simple explanation |
|---|---|
| Cutaneous T-cell lymphoma (CTCL) | This is a rare type of blood cancer that affects the skin. Photopheresis therapy was first introduced as a treatment for this disease. When the treated lymphocytes are reintroduced into the body, they help destroy cancer cells. |
| Graft versus Host Disease (GVHD) | After something like a bone marrow transplant, the newly received stem cells can start to attack your own body as if it were an 'enemy.' This treatment can stop or control that unwanted attack. |
| Organ transplant rejection | After a major organ transplant, such as a lung, liver, or heart, the body's immune system may reject the new organ. This treatment helps prevent that. |
Other medical conditions
In addition to these main conditions, doctors may recommend photopheresis for several other medical conditions.
- Crohn's disease
- Eczema (Atopic dermatitis)
- Scleroderma
- Psoriasis, a skin disease
- Type 1 diabetes
How should we prepare before treatment?
Your doctor will explain this to you. Usually, they will ask you to take care of these things before treatment.
- Drink plenty of water: Drink at least 8 glasses of water a day for two days before treatment. This will help your blood flow better, making it easier to draw blood during treatment.
- Avoid caffeine and alcohol: Things like tea, coffee, and alcohol can dehydrate the body, which slows down blood flow.
- Avoid fatty foods: When you eat foods that are high in fat, such as fried foods and sweets, it can be a little difficult for the machine that separates white blood cells from the blood to do its job.
How does this treatment work?
This entire process takes place while you lie comfortably on a bed. It is a painless procedure.
1. Blood draw: A nurse or doctor will draw blood from a vein in your arm or through a special tube (catheter) placed in your chest. If necessary, a numbing cream may be applied to the area to prevent pain.
2. Cell separation: The blood you take goes directly into a special machine. This machine separates only the white blood cells called lymphocytes from the red blood cells and platelets in your blood.
3. Adding medication: A safe herbal medicine called `8-methoxypsoralen (8-MOP)` is added to the separated white blood cells. This medicine only works when exposed to light.
4. Light therapy: Now, the white blood cells that are with this medicine are exposed to ultraviolet A light (UVA light) inside the machine. Then, the medicine takes effect and changes the function of the white blood cells.
5. Reinfusion: Finally, the white blood cells that have been treated in this way are infused back into your body, along with the other previously separated blood components.
This entire process can take about 3-4 hours.
What are the side effects and things we should be aware of?
Photopheresis is considered a very safe treatment , and most people do not experience any side effects.
However, sometimes minor things can happen.
- Your blood pressure may drop slightly during treatment. If this happens, you may be given intravenous fluids to bring it back to normal.
- You may feel nauseous, dizzy, or cold, just like when donating blood. If you feel this way, tell the nurse immediately.
- You may experience redness, dizziness, or a fever 6-8 hours after treatment. If your fever is higher than 37.8 degrees Celsius (100 degrees Fahrenheit), tell your doctor. He or she may recommend taking a medicine like paracetamol.
Things we need to be especially careful about after treatment
This is very important. Photopheresis treatment makes your skin and eyes very sensitive to sunlight.
Avoid exposure to direct and indirect sunlight for 24 hours after treatment. Indirect sunlight is light coming from a window or curtain.
- If you go outside, wear clothing that covers your entire body. Use a sunscreen with an SPF of 30 or higher.
- Wear sunglasses that protect against UVA rays, both indoors and outdoors, for 24 hours. "wraparound" sunglasses that cover both eyes are best.
How long does it take to see results?
This will vary depending on your condition and the number of treatments. Some people see a significant improvement in their symptoms within 3-4 months. For some conditions (such as scleroderma), it may take 6-12 months for symptoms to improve. Therefore, patience is important with this treatment. Ask your doctor about the time frame you can expect to see results based on your condition.
Take-Home Message
- Photopheresis is a safe treatment that uses light to treat your own white blood cells and control the activity of the immune system.
- This is mainly used for things like CTCL cancer, GVHD conditions, and preventing rejection after organ transplants.
- The treatment is painless, but sun protection is mandatory for 24 hours after treatment.
- It may take some time to see results, so it is important to be patient and seek treatment.
- Talk openly with your doctor about any problems, fears, or doubts you have about this.
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