The use of photochemotherapy for the treatment of cutaneous T-cell lymphoma (CTCL) was first reported by Gilchrest et al. in 1976. 1 Oral 8-methoxypsoralen (8MOP) was administered to patients with early-stage disease, followed by photoactivation with ultraviolet-A irradiation to the skin. This technique, referred to as PUVA, has since become a mainstay of therapy for CTCL and other inflammatory skin conditions. In the early 1980s PUVA was modified for the treatment of CTCL patients with more advanced disease. Subsequent to oral 8MOP administration, whole blood was collected and enriched for white blood cells. The leukocyte-enriched population was then irradiated with UVA and returned to the patient intravenously. This technique was referred to as extracorporeal photopheresis (ECP) and represented the first ‘‘systemic’’form of PUVA therapy.

In 1987 Edelson published the first report documenting the use of ECP in the treatment of patients with erythrodermic CTCL. 2 A 73% overall clinical response rate was reported, with a median survival time of 62 months from the onset of erythroderma. 3 In comparison to historical controls, ECP was associated with improved survival and decreased morbidity among patients with similar clinical characteristics. In 1988, ECP was approved by the US Food and Drug Administration (FDA) for the treatment of CTCL. Aside from its proven effectiveness in the management of CTCL, ECP has been shown to be of clinical benefit in the treatment of systemic sclerosis, cutaneous graft-versus-host disease, systemic lupus erythromatosis (SLE), allograft rejection, and potentially other autoimmune conditions. 4-7 Numerous studies have addressed the utility of ECP for CTCL both as a monotherapy and in combination with other biologic response modifying agents. Over the