We conducted a retrospective study of 72 consecutive pediatric patients treated with extracorporeal photochemotherapy/photopheresis for acute graft-versus-host disease.

Twenty-one steroid-refractory, 21 steroid-dependent, and 30 patients with infectious complications were included.

The infectious complications group included 9 with no steroids before extracorporeal photochemotherapy/photopheresis and 21 with steroids.

Outcomes at the end of extracorporeal photochemotherapy/photopheresis were complete remission, 72%; transplantation-related mortality day +180, 4%; 5-year overall survival, 71%; time to progression, 81%; and progression-free survival, 72%.

Extracorporeal photochemotherapy/photopheresis was highly effective in acute graft-versus-host disease without negative impact on primary disease.