{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:38:17Z","timestamp":1776836297251,"version":"3.51.2"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Chronic graft-versus-host disease (cGvHD) is a major cause of morbidity after allogeneic hematopoietic stem cell transplantation. Ruxolitinib (RUX) is a standard second-line treatment for steroid-refractory or -dependent cGvHD, while extracorporeal photopheresis (ECP), an autologous cell-based immunomodulatory procedure, is also widely used. However, comparative real-world data on combined immunomodulation with the RUX-ECP combination are scarce. We conducted a retrospective single-center analysis of patients with steroid-refractory or -dependent cGvHD receiving RUX-ECP (n=30) or ECP alone (n=21) between 2012 and 2025. The overall response rate was 77% with RUX-ECP and 52% with ECP (p=0.13), with CR rates of 17% and 10% (p=0.69). RUX-ECP was associated with a significantly shorter time to first response (2.6 vs. 12.3 months, p=0.0249). Organ-specific trends favored RUX-ECP in gastrointestinal, ocular and cutaneous cGvHD, whereas both regimens showed limited activity in pulmonary disease. Overall survival, relapse incidence and non-relapse mortality were comparable. At 12 months, complete steroid discontinuation (69% vs. 10%; p=0.005) and relative corticosteroid reduction were significantly greater with RUX-ECP (88% vs. 30%; p=0.0026). Toxicities of RUX-ECP were manageable and consistent with the known RUX profile, and several patients discontinued therapy after stable responses. Thus, combined immunomodulation with RUX-ECP showed high and fast response rates, a favorable safety profile and substantial steroid-sparing, supporting further evaluation in steroid-refractory or -dependent cGvHD patients.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1802710","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T04:39:45Z","timestamp":1776832785000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracorporeal photopheresis alone or in combination with ruxolitinib for the treatment of chronic graft-versus-host disease"],"prefix":"10.3389","volume":"17","author":[{"given":"Christian","family":"Koch","sequence":"first","affiliation":[{"name":"Department of Medical Oncology and Hematology, University Hospital Zurich","place":["Zurich, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus G.","family":"Manz","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, University Hospital Zurich","place":["Zurich, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirjam","family":"N\u00e4geli","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Zurich","place":["Zurich, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Schneidawind","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, University Hospital Zurich","place":["Zurich, Switzerland"]},{"name":"Comprehensive Cancer Center Zurich, University Hospital Zurich and University of Zurich","place":["Zurich, Switzerland"]},{"name":"Department of Medicine II, Faculty of Medicine, University of T\u00fcbingen","place":["T\u00fcbingen, 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