Hamasaki Yoshifumi, Matsuura Ryo, Shinagawa Takahide, Ishihara Soichiro, Ihara Sozaburo, Fujishiro Mitsuhiro, Doi Kent, Nangaku Masaomi
Department of Hemodialysis and Apheresis, The University of Tokyo Hospital, Tokyo, Japan.
Department of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
J Clin Med Res. 2024 Dec;16(12):625-634. doi: 10.14740/jocmr6071. Epub 2024 Dec 20.
Granulocyte and monocyte adsorption apheresis (GMA) is a therapeutic option for remission induction in the active ulcerative colitis (UC) patients. Effects of high processed blood volume of GMA as remission induction therapy on the long-term prognosis of UC patients have remained unclear. For this study, we investigated the relation between re-exacerbation of UC and the processed blood volume of GMA performed as induction therapy.
Data from UC patients treated using a total of 10 GMA sessions as remission induction therapy during 2012 - 2022 were retrospectively collected and analyzed. The relation between the GMA dose, processed blood volume of GMA divided by body weight, and UC re-exacerbation requiring inpatient treatment within 1 year was evaluated.
This study examined data of 72 active UC patients, with median age of 44.4 years (65% male) and median GMA dose of 34.2 mL/kg/session. Kaplan-Meier analysis showed the 1-year exacerbation-free rate was significantly higher in the higher GMA dose group than in the lower GMA dose group (P = 0.008). Cox proportional hazards regression analyses revealed a higher GMA dose as inversely associated with the re-exacerbation of UC within 1 year (hazard ratio: 0.36, 95% confidence interval: 0.17 - 0.78). Extended treatment time of GMA session beyond 60 min contributed to achieving the higher GMA dose and did not increase unexpected treatment termination because of clotting.
Greater processed blood volume of GMA per patient body weight may be associated with a lower 1-year exacerbation rate in UC patients.
粒细胞和单核细胞吸附分离术（GMA）是活动性溃疡性结肠炎（UC）患者缓解诱导的一种治疗选择。GMA作为缓解诱导疗法，高处理血量对UC患者长期预后的影响尚不清楚。在本研究中，我们调查了UC复发与作为诱导疗法的GMA处理血量之间的关系。
回顾性收集并分析了2012年至2022年期间共接受10次GMA治疗作为缓解诱导疗法的UC患者的数据。评估了GMA剂量、GMA处理血量除以体重与1年内需要住院治疗的UC复发之间的关系。
本研究检查了72例活动性UC患者的数据，中位年龄为44.4岁（65%为男性），中位GMA剂量为34.2 mL/kg/疗程。Kaplan-Meier分析显示，高GMA剂量组的1年无加重率显著高于低GMA剂量组（P = 0.008）。Cox比例风险回归分析显示，较高的GMA剂量与1年内UC复发呈负相关（风险比：0.36，95%置信区间：0.17 - 0.78）。GMA疗程延长至60分钟以上有助于达到更高的GMA剂量，且不会因凝血而增加意外治疗终止的情况。
每位患者体重的GMA处理血量增加可能与UC患者较低的1年加重率相关。
