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

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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.

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Authors and Affiliations

  1. Department of Internal Medicine, Sakura Hospital, Toho University, Chiba University School of Medicine, Tokyo, Japan

    Yasuo Suzuki, Katsuyuki Fukuda & Koji Shirai

  2. Department of Internal Medicine, Social Insurance Chuo General Hospital, Chiba University School of Medicine, Tokyo, Japan

    Naoki Yoshimura & Yasushi Saito

  3. Japan Immunoresearch Laboratories, Takasaki, Japan

    Abbi R. Saniabadi

  4. Sakura Hospital, Faculty of Medicine, Toho University, 564-1 Shimoshizu, Sakura City, Chiba, 285-874, Japan

    Yasuo Suzuki

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  1. Yasuo Suzuki
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  2. Naoki Yoshimura
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  3. Katsuyuki Fukuda
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  4. Koji Shirai
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  5. Yasushi Saito
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  6. Abbi R. Saniabadi
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Correspondence to Yasuo Suzuki.

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Suzuki, Y., Yoshimura, N., Fukuda, K. et al. A Retrospective Search for Predictors of Clinical Response to Selective Granulocyte and Monocyte Apheresis in Patients With Ulcerative Colitis. Dig Dis Sci 51, 2031–2038 (2006). https://doi.org/10.1007/s10620-006-9199-9

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  • DOI: https://doi.org/10.1007/s10620-006-9199-9

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