Influence of Leukocytapheresis Therapy for Ulcerative Colitis on Anemia and Hemodynamics

Abstract:  In Japan, leukocytapheresis (LCAP) therapy has been carried out for ulcerative colitis as an effective therapy with a low incidence of side‐effects. In the present study, we serially investigated the influence of LCAP therapy on anemia and hemodynamics in patients with ulcerative colitis using a non‐invasive method with a Crit‐Line monitor (CLM) (Hema Metrics Inc., Salt Lake City, UT and Boston, MA, USA). We carried out LCAP on 10 patients with ulcerative colitis using a CS‐100 Cellsorba EX LCAP filter in 34 courses of LCAP. The mean hematocrit value, which was measured using the Crit‐Line monitor, was 21.8 ± 0.2% (21.0–22.4%), which showed no significant changes after each LCAP therapy. The actual erythrocyte count, hemoglobin and hematocrit values decreased by 244 000/mm3, 0.7 g/dL and 2.1%, respectively, however, the differences were insignificant. These values corresponded to 7.8, 8.0 and 7.6% of the values before LCAP, respectively. There were no significant changes in systolic blood pressure, diastolic blood pressure, or heart rate during LCAP. The results of this study suggest that one course of LCAP does not exacerbate anemia, and it does not influence hemodynamics. However, considering the exacerbation of anemia in patients with severe ulcerative colitis caused by massive melena, monitoring with a less invasive Crit‐Line monitor and a vital information monitor might be useful. 

[1]  K. Amano,et al.  Leukocytapheresis with leukocyte removal filter as new therapy for ulcerative colitis. , 1997, Therapeutic apheresis : official journal of the International Society for Apheresis and the Japanese Society for Apheresis.

[2]  H. Hashimoto,et al.  Fluctuations in the peripheral blood leukocyte and platelet counts in leukocytapheresis in healthy volunteers. , 2002, Therapeutic apheresis.

[3]  T. Hidaka,et al.  Filtration leukocytapheresis therapy in rheumatoid arthritis: a randomized, double-blind, placebo-controlled trial. , 1999, Arthritis and rheumatism.

[4]  K. Mitsuyama,et al.  Suppression of interleukin-1β- and tumor necrosis factor-·-induced inflammatory responses by leukocytapheresis therapy in patients with ulcerative colitis , 2004, Journal of Gastroenterology.

[5]  Naokuni Yamawaki,et al.  Cellsorba , 2003, Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy.

[6]  T. Kondoh,et al.  Evaluation of a filtration lymphocytapheresis (LCP) device for use in the treatment of patients with rheumatoid arthritis. , 2000, Artificial organs.

[7]  T. Shimoyama,et al.  Effect of leukocytapheresis therapy using a leukocyte removal filter in Crohn's disease. , 1999, Internal medicine.

[8]  A. Munakata,et al.  Leukocytapheresis in Ulcerative Colitis: Results of a Multicenter Double-Blind Prospective Case-Control Study with Sham Apheresis as Placebo Treatment , 2005, The American Journal of Gastroenterology.

[9]  S. Yamasaki,et al.  Evaluation of filtration leucocytapheresis for use in the treatment of patients with rheumatoid arthritis. , 2000, Rheumatology.

[10]  T. Hibi,et al.  Multicenter randomized controlled trial for the treatment of ulcerative colitis with a leukocytapheresis column. , 2003, Current pharmaceutical design.