Acute mechanical hemolysis as a complication of extracorporeal photopheresis in a low-weight child Academic Article uri icon


MeSH Major

  • Graft vs Host Disease
  • Photopheresis


  • Graft-versus-host disease (GVHD) is a complication of allogeneic hematopoietic stem cell transplantation with high morbidity and mortality. Extracorporeal photopheresis (ECP) is an effective therapy for treating medication-refractory GVHD, however, there is scant evidence of whether ECP can be safely performed in patients weighing less than 15 kg. Here, we report the implementation of a successful protocol to perform ECP in a 21-month-old, 10.6 kg female with medication-refractory GVHD. Our initial ECP treatment resulted in significant hemolysis that was most likely mechanical. After procedural adjustments that included modifying the anticoagulation dose and whole blood:anticoagulant ratio, as well as whole blood processing time, the patient tolerated future procedures safely without hemolysis or other adverse events. With appropriate technical modifications, we provide a framework for safely performing ECP in children less than 15 kg.

publication date

  • December 2017



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1002/jca.21520

PubMed ID

  • 27891662

Additional Document Info

start page

  • 571

end page

  • 573


  • 32


  • 6