A retrospective study to investigate the efficacy and safety of granulocyte and monocyte adsorptive apheresis in patients with primary sclerosing cholangitis with ulcerative colitis

IF 1.4 4区医学 Q4 HEMATOLOGY

Journal of Clinical Apheresis Pub Date : 2023-11-21 DOI:10.1002/jca.22099

Ayumi Ito, Shun Murasugi, Maria Yonezawa, Teppei Omori, Shinichi Nakamura, Katsutoshi Tokushige

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引用次数: 0

Abstract

Background and Aims

Primary sclerosing cholangitis has a poor prognosis and can be accompanied by ulcerative colitis. Infection control is essential, so immunosuppressive drugs should ideally be preferably. Granulocyte and monocyte adsorptive apheresis does not suppress the immune system and is used to treat ulcerative colitis. Therefore, this study investigated the efficacy and safety of granulocyte and monocyte adsorptive apheresis in patients with primary sclerosing cholangitis and ulcerative colitis.

Methods

We retrospectively evaluated data from patients with primary sclerosing cholangitis with ulcerative colitis who visited our hospital from April 2000 to December 2022 and underwent granulocyte and monocyte adsorptive apheresis (n = 10, number of treatment cycles = 15). Study endpoints were remission induction rate and safety, assessed as changes in liver functions and adverse events.

Results

Seven of the 10 patients were male. The median (min-max) age was 23 (18-77) years. The most common disease type was right-dominant pancolitis. Remission occurred after 86.6% of cycles (13/15). Serum alkaline phosphatase and Aspartate transaminase were significantly lower after treatment (P = .0124, P = .002), and no negative effects on liver function were seen. The only adverse events were headache (n = 1) and decreased blood pressure (n = 1).

Conclusions

Granulocyte and monocyte adsorptive apheresis has high efficacy for intestinal lesions and improves alkaline phosphatase and aspartate transaminase levels (high levels are a poor prognosis factor). It appears to be a treatment option in patients with primary sclerosing cholangitis associated with ulcerative colitis.

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回顾性研究粒细胞和单核细胞吸附分离治疗原发性硬化性胆管炎合并溃疡性结肠炎的疗效和安全性。

背景与目的:原发性硬化性胆管炎预后差，可合并溃疡性结肠炎。感染控制是至关重要的，因此免疫抑制药物应该是理想的。粒细胞和单核细胞吸附分离不抑制免疫系统，用于治疗溃疡性结肠炎。因此，本研究探讨了粒细胞和单核细胞吸附采珠术治疗原发性硬化性胆管炎和溃疡性结肠炎的疗效和安全性。方法:回顾性分析2000年4月至2022年12月在我院接受粒细胞和单核细胞吸附采珠术治疗的原发性硬化性胆管炎合并溃疡性结肠炎患者的资料(n = 10，治疗周期数= 15)。研究终点是缓解诱导率和安全性，以肝功能的变化和不良事件来评估。结果:10例患者中男性7例。中位(最小-最大)年龄为23岁(18-77岁)。最常见的疾病类型为右显性全结肠炎。86.6%(13/15)的周期后出现缓解。治疗后血清碱性磷酸酶和天冬氨酸转氨酶显著降低(P =。0124, P = .002)，肝功能未见不良影响。唯一的不良事件是头痛(n = 1)和血压下降(n = 1)。结论:粒细胞和单核细胞吸附采珠术治疗肠道病变疗效高，可提高碱性磷酸酶和天冬氨酸转氨酶水平(高水平为预后不良因素)。它似乎是原发性硬化性胆管炎合并溃疡性结肠炎患者的一种治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Apheresis 医学-血液学

CiteScore

2.80

自引率

13.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Clinical Apheresis publishes articles dealing with all aspects of hemapheresis. Articles welcomed for review include those reporting basic research and clinical applications of therapeutic plasma exchange, therapeutic cytapheresis, therapeutic absorption, blood component collection and transfusion, donor recruitment and safety, administration of hemapheresis centers, and innovative applications of hemapheresis technology. Experimental studies, clinical trials, case reports, and concise reviews will be welcomed.