title: The Italian Registry of Therapeutic Apheresis: granulocyte-monocyte apheresis in the treatment of inflammatory bowel disease. A multicentric study.
abstract: Leukocytes are thought to play an important role in the pathogenesis of inflammatory bowel diseases; granulocyte-monocyte adsorptive (GMA) apheresis, an extracorporeal technique aimed at removing activated circulating leukocytes from the blood, may represent a safe and effective therapeutic tool in these patients. The Italian Registry of Therapeutic Apheresis performed an observational, multicentric study involving 24 Gastroenterology Units. In this study, laboratory data and clinical outcomes of 230 patients (148 males, mean age 43.5 years) affected with ulcerative colitis (UC, n = 194) or Crohn's disease (CD, n = 36) who underwent one or more cycles of GMA were analyzed. Each cycle consisted of five GMA treatments. The patients were followed up for a mean of 8.7 (min. 3 to max. 12) months. At 3 months, positive outcome was achieved in 77.7% of UC patients (72.0% remission, 5.7% clinical response) and 61.3% of CD patients (54.8% remission, 6.5% clinical response). The cumulative proportion of positive outcome at 12 months was 87.1% for UC patients (83.7% remission, 3.4% clinical response) and 77.4% for CD patients (74.2% remission, 3.2% clinical response). No single clinical or laboratory parameter among those analyzed (age, sex, disease characteristics, history of smoking, medication history, baseline values of clinical activity index (CAI)/Crohn's disease activity index (CDAI), hemoglobin, white blood cells count, and erythrocyte sedimentation rate) was independently associated with clinical outcome. The procedure was well tolerated with no significant adverse effects registered.
authors.affiliation: Nephrology Division, Università Cattolica del Sacro Cuore, Roma, Italy. passalacqua@aferesi.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Passalacqua
authors.forename: Pietro Manuel
authors.initials: PM
authors.lastname: Ferraro
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Bresci
authors.forename: Valeria
authors.initials: V
authors.lastname: D'Ovidio
authors.forename: Marco
authors.initials: M
authors.lastname: Astegiano
authors.forename: Mariabeatrice
authors.initials: M
authors.lastname: Principi
authors.forename: Roberto
authors.initials: R
authors.lastname: Testa
authors.forename: Renata
authors.initials: R
authors.lastname: D'Incà
authors.forename: Daniela
authors.initials: D
authors.lastname: Valpiani
authors.forename: Alessandro
authors.initials: A
authors.lastname: Armuzzi
authors.forename: Renato
authors.initials: R
authors.lastname: Sablich
authors.forename: Flaminia
authors.initials: F
authors.lastname: Cavallaro
authors.forename: Francesco
authors.initials: F
authors.lastname: Costa
authors.forename: Vincenza
authors.initials: V
authors.lastname: Di Leo
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Colombo
authors.forename: Alessia
authors.initials: A
authors.lastname: Santini
authors.forename: Annalisa
authors.initials: A
authors.lastname: Aratari
authors.forename: Pierenrico
authors.initials: P
authors.lastname: Lecis
authors.forename: Valeria
authors.initials: V
authors.lastname: Saladino
authors.forename: Gabriele
authors.initials: G
authors.lastname: Riegler
authors.forename: Marino
authors.initials: M
authors.lastname: Marco
authors.forename: Francesca
authors.initials: F
authors.lastname: Calella
authors.forename: Chiara
authors.initials: C
authors.lastname: Ricci
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Guidi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Repaci
authors.forename: Michele
authors.initials: M
authors.lastname: Silla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000097:blood / Q000628:therapy; D003424:Crohn Disease / Q000097:blood / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006098:Granulocytes; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000628:therapy*; D007558:Italy; D007937:Leukapheresis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D012042:Registries; D012074:Remission Induction; D016896:Treatment Outcome; D055815:Young Adult