Frequently Asked Questions About Photopheresis

This information explains photopheresis, including how to prepare for the procedure and what to expect afterward.

What is photopheresis?

Photopheresis, or extracorporeal photoimmune therapy, is a procedure that may be recommended by your doctor to treat graft versus host disease (GVHD) or cutaneous T-cell lymphoma (CTCL).

During photopheresis, some of your blood is taken from your vein and separated into its different components: white blood cells, red blood cells, and platelets. Your white blood cells are treated with a medication called methoxsalen, exposed to ultraviolet (UV) light, and then returned to you, along with your other blood cells. These treated cells stimulate your immune system to help your body fight GVHD and CTCL.

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How do I prepare for photopheresis?

A few days before your procedure, your doctor or nurse will examine your veins to see if they can be used for the procedure. If they cannot, you will have a central venous catheter (CVC) placed in a large vein below your collar bone. Your blood will be drawn from the CVC for the photopheresis procedure. If you need to have a CVC placed, your nurse will give you more information about it.

2 days before your procedure:

  • Drink plenty of liquids. Being well hydrated helps your blood to flow better during your procedure.


The evening before your procedure:

  • Eat a low-fat meal. You should avoid foods such as fried foods, cheese, eggs, butter, and desserts. If you have high levels of fat in your blood, the machine may have trouble separating your blood cells and your procedure may need to be stopped before it is finished.

On the day of your procedure:

  • Eat low-fat meals and do not skip any meals.
  • You will not be able to use the bathroom during photopheresis, so do not drink too much for a few hours before your procedure. If you need to use the bathroom during the procedure, you may use a bedpan or urinal.
  • Bring a list of any medications you are taking, including patches and creams.
  • Wear comfortable clothing with loose sleeves.
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What happens during photopheresis?

Your nurse will insert a needle into your arm or will connect your CVC to the photopheresis machine. The photopheresis machine will draw your blood and separate the white blood cells from the rest of the blood components. Your red blood cells and plasma will be returned to you through your arm or CVC.

Your white blood cells will be treated with a medication called methoxsalen and then exposed to UV light, which activates the medication. The treated white blood cells will then be re-infused into your body through your arm or CVC. The treated cells will stimulate your immune system to fight GVHD or CTCL.

Another medication called heparin is used during the procedure to prevent your blood from clotting in the photopheresis machine.

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How long does photopheresis take?

The procedure usually takes about 3 to 4 hours. After your procedure is finished, your nurse will check your vital signs including your pulse and blood pressure. You will then be able to go home.

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What are the side effects of photopheresis?

  • Methoxsalen will make you very sensitive to UV light the day of your procedure. UV light is found in sunlight and some artificial lighting. You must protect your eyes with sunglasses. Wear them when you are exposed to sunlight for the first 24 hours after your procedure. Your skin will also be sensitive to UV light, so you will need to avoid sunlight on the day of your procedure. If you need to be outside, protect yourself with long sleeved clothing and a wide-brimmed hat. You should also wear sunscreen with an SPF of 30 or higher.
  • Heparin slows the ability of your body to stop bleeding. This should go away within 2 to 4 hours. If you continue to bleed at the needle site, apply pressure to the site for 3-5 minutes until the bleeding stops. If the bleeding still has not stopped or if you see signs of unusual bleeding, call the Blood Donor Room staff (see “Contact Information” section below).
  • You may experience a slight fever (up to 100.3° F or 37.9° C) within 6 to 8 hours after your procedure. Also, your skin may turn slightly red. Both of these side effects should go away within 1 day.
  • Some people experience a drop in blood pressure that can cause lightheadedness or dizziness after the procedure. If this occurs, sit or lie down immediately. Lower your head and elevate your feet to help relieve the symptoms. Drink cool liquids when you feel better.
  • Leave the bandage on the needle site for at least 3 hours after your procedure. Avoid heavy lifting for the rest of the day. You may notice some tenderness or bruising at the needle site. This is normal.
  • You can apply a cold compress to the site for the first 24 hours if there is bruising, then a warm compress if you have discomfort. If the site continues to hurt after several days or seems to be getting worse, contact the Blood Donor Room staff.
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Call Your Doctor or Nurse if You Have:

  • A temperature of 100.4° F (38° C) or higher
  • Skin redness that does not go away after 1 day or gets worse


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Contact Information

If you have any questions or concerns, please contact the Blood Donor Room at 212-639-6178. The Blood Donor Room hours are:

Monday: 8:30 am to 3:30 pm
Tuesday, Wednesday, Thursday: 8:30 am to 8:00 pm

Friday, Saturday, Sunday: 8:30 am to 3:30 pm

After hours, please call 212-639-2000 and ask for the Blood Donor Room doctor on call.

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