Lymphocyte depletion and immunosuppression with repeated leukapheresis by continuous flow centrifugation.

Leukapheresis by continuous flow centrifugation (CFC) was studied in normal volunteers and patients with rheumatoid arthritis to determine whether this procedure. when carried out repeatedly. can cause lympocytopenia and immunosuppression similar to that produced by thoracic duct drainage. The removal of lymphocytes from blood by CFC was maximal in our hands at centrifuge speeds of 900-1 300 rpm and could be related directly to blood flow rates. In addition. it was found that the proportional removal of different lymphocyte subpopulations is affected by the position within the plasma-blood cell interface at which lymphocytes are removed during CFC. Repeated leukapheresis. with techniques designed to favor the removal of T lymphocytes. was carried out in 8 patients with rheumatoid arthritis at a rate of 2-3 CFC/wk for periods of 5-7 wk (total CFC were 13-18/patient). Up to 1 8.6 x 1 010 lymphocytes were removed from the patients (mean 13.0 x 1010 lymphocytes) at an average rate of 3.5 x i0 lymphocytes/day. resulting in significant

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