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Multicenter prospective study for clinical and endoscopic efficacies of leukocytapheresis therapy in patients with ulcerative colitis.

Abstract：

OBJECTIVE:This study aimed to assess the efficacy and tolerability of leukocytapheresis (LCAP) and to investigate predictive factors for mucosal healing and a sustained clinical response in steroid-free and steroid-refractory patients with ulcerative colitis (UC). MATERIAL AND METHODS:Thirty-one steroid-free or steroid-refractory patients with active UC were enrolled. Five or ten consecutive sessions of LCAP were performed in each patient. The efficacy and tolerability was then evaluated at weeks 3 and 6. Endoscopic examination was performed at week 6 to evaluate the mucosal healing, and the sustained cumulative response rate was evaluated at 12 months. RESULTS:At week 6, the mean Mayo clinical activity score had decreased significantly from 8.0 to 4.6 in the steroid-free patients and from 8.3 to 3.9 in the steroid-refractory patients. Rachmilewitz's endoscopic index had also decreased significantly from 9.1 to 6.1 in the steroid-free patients and from 10.0 to 5.7 in the steroid-refractory patients. Forty-seven percent of the steroid-free patients and 33% of the steroid-refractory patients achieved mucosal healing. The peripheral platelet counts had decreased significantly at weeks 3 and 6 in the mucosal healing group, compared with the non-mucosal healing group. The patients with a more than 15% platelet reduction had a significantly higher cumulative response rate, compared with the patients without a platelet reduction (p = 0.015). CONCLUSIONS:LCAP is beneficial for the induction of mucosal healing in steroid-free and steroid-refractory patients with UC. The degree of platelet reduction during LCAP might be a predictive marker for mucosal healing and a sustained clinical response.

journal_name

Scand J Gastroenterol

journal_title

Scandinavian journal of gastroenterology

authors

Okuyama Y,Andoh A,Nishishita M,Fukunaga K,Kamikozuru K,Yokoyama Y,Ueno Y,Tanaka S,Kuge H,Yoshikawa S,Sugahara A,Anami E,Munetomo Y,Watanabe C,Fujiyama Y,Matsumoto T

doi

10.3109/00365521.2012.763175

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

412-8

issue

eissn

0036-5521

issn

1502-7708

journal_volume

pub_type

杂志文章,多中心研究

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Multicenter prospective study for clinical and endoscopic efficacies of leukocytapheresis therapy in patients with ulcerative colitis.