leukapharesis for ulcerative colitis (UC)
Last reviewed 01/2018
Leukapheresis:
- involves extracorporeal removal of leukocytes from the blood, either by centrifugation or through an adsorptive system
- venous
blood is removed in a continuous flow, anticoagulated, processed to deplete the
leukocytes and returned to the circulation
- different apheresis systems remove different populations of white blood cells
- leukapheresis using
centrifugation removes a proportion of neutrophils and lymphocytes
- filter columns, which may contain cellulose acetate beads or a polyester fibre filter, remove a large proportion of granulocytes and monocytes and some also remove lymphocytes
- exact mode of action of these procedures is unknown.
In ulcerative colitis:
- in one randomised controlled 74% (29/39) of patients treated with leukapheresis had an ‘excellent’ or ’moderate’ improvement in symptoms, compared with 38% (14/37) of patients treated with highdose steroids (p = 0.005)
In Crohn's disease:
- a small randomised controlled trial of patients with
Crohn’s disease, 100% (12/12) of patients treated with leukapheresis were successfully
withdrawn from steroid therapy, compared with 67% (10/15) of patients who were
not treated with leukapheresis (p = 0.074)
- no significant difference between the two groups in disease recurrence at 18-month follow-up
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