| Clinical Usefulness of Centrifugal Leukapheresis in the Patients with Steroid-dependent Ulcerative Colitis: Long-term Follow-up Result |
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Hwang Choi, Kyu Yong Choi, Bo In Lee, Hyong Ju Kang, Soo Jeong Park, Byung Wook Kim, Chi Wha Han, In Sik Chung |
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Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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| 스테로이드-의존성 궤양성대장염 환자에서 원심분리 백혈구제거요법의 임상적 유용성: 장기간 추적관찰 결과 |
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최황, 최규용, 이보인, 강형주, 박수정, 김병욱, 한치화, 정인식 |
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가톨릭대학교 의과대학 내과학교실 |
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| Abstract |
Background/Aims
Although the etiologies of ulcerative colitis have not been proven yet, activated leukocytes have a great role in the pathogenesis of ulcerative colitis. We studied to evaluate the long-term clinical usefulness and adverse effect of the leukocyte removal technique (leukapheresis) for the patients with steroid-dependent ulcerative colitis. Methods: Eight patients who had performed leukapheresis for management of steroid-dependent active ulcerative colitis were analyzed retrospectively. We used a centrifugal method (Cobe Spectra, Gambro BCT, Inc, USA) for the leukapheresis. The schedule was one session weekly for 5 weeks of intensive therapy and one session monthly of maintenance therapy. The number of leukapheresis performed was average of 9.5 cycles. The simple clinical colitis activity index (SCCI) and complete blood counts were checked before and after each sessions of leukapheresis. We observed the side effects of leukapheresis and clinical outcomes of the patients over 2 years. Results: After 5 sessions of leukapheresis, the average SCCI decreased from 8.75 to 0.5 (p＜0.001). All patients could easily taper the steroid dose during leukapheresis and 7 patients stopped the use of steroid after leukapheresis. During mean follow-up of 44 months, 4 patients relapsed and started steroid and 6-mercaptopurine. Two patients complained of numbness and parasthesia on the face and fingers during leukapheresis and theses symptoms were relieved after the injection of calcium. Conclusions: Centrifugal leukapheresis was an effective and safe method for the treatment of the patients with steroid-dependent active ulcerative colitis. We expect further prospective controlled studies. (Intestinal Research 2005;3:110-116) |
| Key Words:
Ulcerative colitis, Steroid-dependence, Centrifugal leukapheresis, Apheresis |
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