Digestive Diseases and Sciences

, Volume 51, Issue 11, pp 2031–2038

A Retrospective Search for Predictors of Clinical Response to Selective Granulocyte and Monocyte Apheresis in Patients With Ulcerative Colitis

  • Yasuo Suzuki
  • Naoki Yoshimura
  • Katsuyuki Fukuda
  • Koji Shirai
  • Yasushi Saito
  • Abbi R. Saniabadi
Original Paper
  • 121 Downloads

Abstract

Recently, selective granulocytapheresis (Adacolumn) has appeared as a new treatment for patients with inflammatory bowel disease. This study sought to determine predictors of response to this new nonpharmacologic mode of therapy by retrospectively evaluating 28 patients who received granulocytapheresis after experiencing active ulcerative colitis (UC). Between April 2000 and March 2004, 28 consecutive patients received granulocytapheresis for active UC with the Adacolumn, which is filled with cellulose acetate beads as the column leukocytapheresis carriers; the carriers adsorb granulocytes, monocytes/macrophages, and a small fraction of lymphocytes (FcγR and complement receptors bearing leukocytes). Each patient could receive up to 10 Adacolumn sessions, at 2 sessions per week. In 2004, clinical response was retrospectively evaluated. Seven days after the last Adacolumn session, 20 of 28 patients had remission (colitis activity index [CAI] ≤4) including all 8 patients who had their first UC episode. The mean duration of UC in the 8 first episode cases was 3.4 months compared with 40.2 months for all 28 patients and 65.4 months for the 8 nonresponders. The response to Adacolumn was independent of basal CAI. The 8 nonresponders were given conventional medication (CM) or cyclosporine (CsA) if the former failed. Two responded to CM, 3 to CsA, and 3 underwent colectomy. First UC episode and short disease duration appear good predictors of response to granulocytapheresis. Selective granulocytapheresis might be an effective first-line treatment.

Keywords

Ulcerative colitis First ulcerative colitis episode 5-ASA Selective granulocyte and monocyte adsorptive apheresis Prednisolone Clinical activity index Endoscopic activity index 

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Yasuo Suzuki
    • 1
    • 4
  • Naoki Yoshimura
    • 2
  • Katsuyuki Fukuda
    • 1
  • Koji Shirai
    • 1
  • Yasushi Saito
    • 2
  • Abbi R. Saniabadi
    • 3
  1. 1.Department of Internal Medicine, Sakura HospitalToho University, Chiba University School of MedicineTokyoJapan
  2. 2.Department of Internal MedicineSocial Insurance Chuo General Hospital, Chiba University School of MedicineTokyoJapan
  3. 3.Japan Immunoresearch LaboratoriesTakasakiJapan
  4. 4.Sakura Hospital, Faculty of MedicineToho UniversitySakura City, ChibaJapan

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