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October 1990

Dosage Guidelines: Extracorporeal Photochemotherapy (Photopheresis)

Author Affiliations

Department of Dermatology Yale University School of Medicine 500 LCI, 333 Cedar St New Haven, CT 06510

Arch Dermatol. 1990;126(10):1369. doi:10.1001/archderm.1990.01670340121026

To the Editor.—  Extracorporeal photochemotherapy (photopheresis) has been approved for the treatment of cutaneous T-cell lymphoma. During the clinical trial that documented the effectiveness of this therapy,1 patients were treated with a minimum of 0.6 mg/kg crystalline 8-methoxypsoralen (8-MOP). Proper dosing was confirmed by serum levels obtained at 2 hours, demonstrating a level of 100 ng/mL or greater.Now that a liquid formulation of 8-MOP is available (Oxsoralen-ULTRA, Elder Pharmaceuticals), we have found dosing to be more reliable and more convenient when followed as outlined in this communiqué.Rather than measuring serum levels, we have converted to measuring 8-MOP levels in the treatment bag of photopheresis. The treatment bag contains a 240-mL buffy coat, 200 mL of psoralen-rich plasma, and 200 mL of saline. The rationale is that the serum level represents a single point in time, whereas the treatment bag contains serum collected over several pheresis cycles. Values

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