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Extracorporeal photochemotherapy (ECP) is an alternative treatment approach in the management of chronic graft-versus-host disease (cGVHD). However, few reports have investigated the optimal treatment schedule of ECP. We treated seven pediatric patients with steroid-resistant or -dependent cGVHD with ECP. Using the Therakos UVAR XTS system, ECP was begun three (three patients) or five (four patients) times a week initially. Complete and partial responses were obtained in three patients. Three of seven patients died of GVHD-related complications. In this group initial intensive ECP did not improve the rate of response. However, this schedule appeared well tolerated. Pediatr Blood Cancer 2007;48:218–221. © 2006 Wiley-Liss, Inc.