RESUMO
BACKGROUND: Extracorporeal photopheresis (ECP) has been considered for treatment of patients with systemic sclerosis (SSc). OBJECTIVES: To study the 12-month effects of ECP on laboratory parameters and evaluate the SSc-related long-term survival. METHODS: 59 SSc patients who had received at least 6 ECP cycles were included. Lab parameters were assessed at baseline (ECP naïve), after 6 months, and after 12 months. 20-year follow-up data were collected for all patients. RESULTS: 31 (59/52.5%) patients presented with elevated serum III procollagen (sPIIINP) levels at baseline which significantly declined after 6- and 12-month ECP. Total lymphocyte counts as well as circulating immune complexes (CICs) significantly decreased after 12-months ECP. On long-term follow-up, patients had received a median of 37.5 (6-167) ECP cycles over a median period of 64 (6-281) months. 20-year follow-up revealed only 8 (59/13.6%) SSc-related deaths and 51 (59/86.4%) survivors. CONCLUSIONS: One-year ECP induces changes in lab parameters, such as sPIIINP, CICs, and lymphocyte counts, which have previously been implicated in the pathogenesis of SSc. More importantly, our data reveal, for the first time, that ECP-treated SSc patients appear to have extremely favorable 20-year survival rates compared to other SSc cohorts reported in the literature.
