title: Optimal apheresis treatment volume for the efficacy and safety of leukocytapheresis with Cellsorba in patients with active ulcerative colitis.
abstract: BACKGROUND
  Leukocytapheresis (LCAP) is used as an adjunct therapy for patients with active ulcerative colitis (UC). Although, LCAP is routinely performed at 3,000 mL per session, we were interested to see that if this can be replaced with bodyweight (BW) adjusted volume.
  
  
  METHODS
  In an open label prospective trial, the clinical response to BW adjusted LCAP (BWA-LCAP) was evaluated in 14 patients with active UC. Fourteen demography matched UC patients who had been treated with the routine 3,000 mL LCAP were randomly sampled from our database as a control group. All patients were given 10 weekly LCAP sessions. In the BWA-LCAP group, the processed blood volume (PBV) was set at 30 mL/kg × BW/session. Baseline demographic measures were not significantly different between the two groups.
  
  
  RESULTS
  The average PBV in the BWA-LCAP group was 1971.0 ± 330.0 mL, range 1,020-2,460. In both groups, the average UC clinical disease activity index, the endoscopic index, and the concomitant prednisolone dosage were significantly and equally reduced during the course of 10 LCAP. Accordingly, at the end of the trial, no significant difference was seen in any outcome measure between the two groups. However, a significantly higher incidence of adverse event (AE) was observed in the routine 3,000 mL LCAP group as compared with the BWA-LCAP group (P < 0.01).
  
  
  CONCLUSIONS
  The outcomes of this investigation showed that the therapeutic efficacy of LCAP based on 30 mL/kg × BW is similar to the routine 3,000 mL per session LCAP. However, BWA-LCAP should be favored if one is to see the full potential of LCAP without AE.
authors.affiliation: Division of Lower Gastroenterology, Department of Internal medicine, Hyogo College of Medicine, Japan. kebe@hyo-med.ac.jp
authors.forename: Ken
authors.initials: K
authors.lastname: Fukunaga
authors.forename: Koji
authors.initials: K
authors.lastname: Kamikozuru
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hida
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ohda
authors.forename: Naohisa
authors.initials: N
authors.lastname: Takeda
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshida
authors.forename: Masaki
authors.initials: M
authors.lastname: Iimuro
authors.forename: Risa
authors.initials: R
authors.lastname: Kikuyama
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Kato
authors.forename: Kazuko
authors.initials: K
authors.lastname: Nagase
authors.forename: Shiro
authors.initials: S
authors.lastname: Nakamura
authors.forename: Hiroto
authors.initials: H
authors.lastname: Miwa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001810:Blood Volume; D002648:Child; D003093:Colitis, Ulcerative / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D011446:Prospective Studies; D012449:Safety; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011239:Prednisolone