潰瘍性大腸炎に対する白血球除去療法の有用性について : 繊維を用いた白血球系細胞除去療法

概要

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The feasibility of leukapheresis for UC was estimated from the condition of the patients. Filter (Imugard, Terumo Co., Ltd., Japan) leukapheresis was done once weekly for 3 weeks, the intensive period, followed by once every two to eight weeks. Fourteen hundred milliliters of whole blood was processed in one treatment. Heparin was used as an anticoagulant. Feasibility was estimated from the clinical response rate, side effects, cost-effectiveness, and QOL, analyzed from 34 patients who had been treated at least four years. Thirty-one (91%) of 34 patients achieved complete remission (21) or had some beneficial effects (10) such as corticosteroids tapering or improvement in laboratory data. No effect was seen in 3 patients (9%). Twenty-six of 34 patients discontinued treatment ; 14 showed complete remission, 9 showed improvement, and 3 no change. Nine patients stopped leukapheresis in spite of improvement : 3 had complications during treatment, one died of another disease, 4 stopped for geographical reasons, and one for insufficient effect. Eight of 34 patients continued leukapheresis : 7 showed complete remission and one improvement. The frequency of the treatment was less than once a month in six patients. No patient's condltions deteriorated. Leukapheresis appears to be feasible treatment in terms of cluick effect, high response rate, steroid sparing effect, and maintenance of the effect.
日本アフェレシス学会の論文
2000-02-29