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Although ruxolitinib, a selective Janus kinase (JAK)1\/2 inhibitor demonstrated significantly higher response rates in randomized trials compared to the best available therapy, and thus, is of benefit in both acute as well as chronic GvHD, there is an urgent medical need to improve results, such as durability of responses, response in eye, liver and lung manifestations and reduction of infectious complications. In this \u201cReview\u201d article we would like to offer strategies for improving treatment results in patients with steroid-refractory GvHD by combining ruxolitinib with extracorporeal photopheresis (ECP), a leukapheresis-based immunomodulatory treatment frequently applied in T-cell mediated immune disease including GvHD. Our article explores key published evidence supporting the clinical efficacy of both ruxolitinib and ECP in the treatment of GvHD and highlights their potentially complementary mechanisms of action.<\/jats:p>","DOI":"10.1038\/s41375-022-01701-2","type":"journal-article","created":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T10:05:04Z","timestamp":1664013904000},"page":"2558-2566","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Extracorporeal photopheresis in acute and chronic steroid\u2011refractory graft-versus-host disease: an evolving treatment landscape"],"prefix":"10.1038","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2780-3300","authenticated-orcid":false,"given":"Hildegard T.","family":"Greinix","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Ayuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6565-3393","authenticated-orcid":false,"given":"Robert","family":"Zeiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,9,24]]},"reference":[{"key":"1701_CR1","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.3324\/haematol.2020.265769","volume":"107","author":"HT Greinix","year":"2022","unstructured":"Greinix HT, Eikema DJ, Koster L, Penack O, Yakoub-Agha I, Montoto S, et al. Improved outcome of patients with graft-versus-host disease after allogeneic hematopoietic cell transplantation for hematologic malignancies over time: an EBMT mega-file study. Haematologica. https:\/\/doi.org\/10.3324\/haematol.2020.265769 2022;107:1054\u201363.","journal-title":"Haematologica"},{"key":"1701_CR2","doi-asserted-by":"publisher","first-page":"2167","DOI":"10.1056\/NEJMra1609337","volume":"377","author":"R Zeiser","year":"2017","unstructured":"Zeiser R, Blazar BR. Acute graft-versus-host disease - biologic process, prevention, and therapy. N. Engl J Med. 2017;377:2167\u201379.","journal-title":"N. Engl J Med"},{"key":"1701_CR3","doi-asserted-by":"publisher","first-page":"79","DOI":"10.3389\/fimmu.2017.00079","volume":"8","author":"S Ghimire","year":"2017","unstructured":"Ghimire S, Weber D, Mavin E, Wang XN, Dickinson AM, Holler E. Pathophysiology of GvHD and other HSCT-related major complications. 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