Sawada K, Ohnishi K, Kosaka T, Egashira A, Yamamura M, Satomi M, Shimoyama T
Department of Internal Medicine 4, Hyogo College of Medicine, Nishinomiya, Japan.
Nihon Geka Gakkai Zasshi. 1997 Apr;98(4):438-42.
Major inclusion criteria for leukocytapheresis (LCAP) therapy were mainly insufficient response to conventional drugs therapy. LCAP was administered once a week for 5 weeks of intensive therapy and once approximately a month for maintenance therapy, for 38 patients with UC. LCAP could remove approximately 1 x 10(10) white blood cells in each session. In the evaluation, we classified the response to the LCAP as: 1) excellent, 2) moderately improved, 3) no change, and 4) deterioration. Clinical improvement was recognized in 29 of 38 patients (76%) including 8 with dramatic response during the intensive therapy, and continued throughout the maintenance therapy in 26 patients (68.4%). Even though their symptoms were mild, the patients with more than 5 years UC history seemed to be not effective. The patients with moderately improvement and with excellent response have kept remission for about 20 months and about 2.5 years on an average, respectively. Clinical and blood examinations showed no side effects in any cases. It suggests that LCAP is able to be a UC treatment between drug therapies and an operation.
白细胞去除术(LCAP)治疗的主要纳入标准主要是对传统药物治疗反应不足。对38例溃疡性结肠炎(UC)患者进行了治疗,强化治疗阶段每周进行1次白细胞去除术,共进行5周,维持治疗阶段大约每月进行1次。每次白细胞去除术大约可去除1×10¹⁰个白细胞。在评估中,我们将对白细胞去除术的反应分为:1)优,2)中度改善,3)无变化,4)恶化。38例患者中有29例(76%)临床症状得到改善,其中8例在强化治疗期间有显著反应,26例(68.4%)在维持治疗期间症状持续改善。尽管症状较轻,但病程超过5年的患者似乎效果不佳。中度改善和优反应的患者平均分别维持缓解约20个月和约2.5年。临床和血液检查在所有病例中均未显示出副作用。这表明白细胞去除术能够成为介于药物治疗和手术之间的一种溃疡性结肠炎治疗方法。