title: Treatment-free remission in severe systemic lupus erythematosus following synchronization of plasmapheresis with subsequent pulse cyclophosphamide.
abstract: OBJECTIVE
  To investigate the effect of an intensified treatment protocol synchronizing plasmapheresis with subsequent pulse cyclophosphamide for severe systemic lupus erythematosus (SLE).
  
  
  METHODS
  A protocol of plasmapheresis (3 x 60 ml/kg) and subsequent high-dose pulse cyclophosphamide (36 mg/kg) followed by 6 months of peroral immunosuppression was used to treat 14 patients with severe SLE.
  
  
  RESULTS
  Rapid improvement was achieved in all patients. Immunosuppressants, including corticosteroids, were withdrawn at month 6 in 12 patients. Eight patients continued without treatment for a mean observation period of 5.6 years (46-91 months).
  
  
  CONCLUSIONS
  The results demonstrate that treatment-free clinical remission can be achieved in some patients with severe SLE.
authors.affiliation: Christian Albrecht University, Kiel, Germany.
authors.forename: H H
authors.initials: HH
authors.lastname: Euler
authors.forename: J O
authors.initials: JO
authors.lastname: Schroeder
authors.forename: P
authors.initials: P
authors.lastname: Harten
authors.forename: R A
authors.initials: RA
authors.lastname: Zeuner
authors.forename: H J
authors.initials: HJ
authors.lastname: Gutschmidt
mesh_terms: D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000503:physiopathology; D003181:Complement C4 / Q000032:analysis / Q000172:deficiency; D003404:Creatinine / Q000097:blood; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007136:Immunoglobulins / Q000378:metabolism; D007700:Kinetics; D007958:Leukocyte Count; D007970:Leukopenia / Q000209:etiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D010956:Plasmapheresis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011673:Pulsatile Flow; D013997:Time Factors
chemical_list: D003181:Complement C4; D007136:Immunoglobulins; D003520:Cyclophosphamide; D003404:Creatinine