Edfors Kajsa, Ståhlberg Dagny, Söderman Charlotte
Gastroenterology Unit, Department of Medicine, Capio St. Goran Hospital, Stockholm, Sweden.
Ther Apher Dial. 2016 Feb;20(1):79-85. doi: 10.1111/1744-9987.12336. Epub 2016 Feb 2.
Patients with active inflammatory bowel disease (IBD) have elevated and activated myeloid leukocytes, which infiltrate the intestinal mucosa. A significant proportion of IBD patients do not respond adequately to conventional treatment regimes. Studies have suggested that treatment with granulocyte monocyte apheresis (GMA) could be a safe and efficacious alternative for these patients. We evaluated the efficacy and safety of granulocyte/monocyte apheresis in patients with IBD in a retrospective cohort study, conducted from a single center in Stockholm. Clinical details from consecutive apheresis treated patients were retrospectively reviewed from 2004 to 2012. A total of 37 patients were included, 23 patients with ulcerative colitis (UC) and 14 with Crohn's disease (CD). Clinical response was seen in 11 patients (30%) and complete remission in 11 patients (30%). The remission rate was higher in UC patients compared to CD patients, 39% (N = 9) and 14% (N = 2) respectively. A total of 9 patients experienced adverse events. Most frequently reported was headache (N = 4). GMA seems to be a valuable adjuvant treatment regime in the care of patients with refractory IBD.
患有活动性炎症性肠病(IBD)的患者骨髓白细胞升高且被激活,这些细胞浸润肠黏膜。相当一部分IBD患者对传统治疗方案反应不佳。研究表明,粒细胞单核细胞分离术(GMA)治疗可能是这些患者的一种安全有效的替代方法。我们在一项来自斯德哥尔摩单一中心的回顾性队列研究中评估了粒细胞/单核细胞分离术对IBD患者的疗效和安全性。对2004年至2012年连续接受分离术治疗患者的临床细节进行了回顾性审查。共纳入37例患者,其中23例溃疡性结肠炎(UC)患者和14例克罗恩病(CD)患者。11例患者(30%)出现临床缓解,11例患者(30%)完全缓解。UC患者的缓解率高于CD患者,分别为39%(N = 9)和14%(N = 2)。共有9例患者发生不良事件。最常报告的是头痛(N = 4)。GMA似乎是难治性IBD患者护理中的一种有价值的辅助治疗方案。