サイタフェレシスにおける安全性と留意点(<特集>アフェレシスにおけるセイフティーマネジメント)  [in Japanese] Adverse Events and Safety in the Cytapheresis Therapy  [in Japanese]

Cytapheresis is a treatment aiming to improve pathophysiology and/or symptoms of a disease in which certain kinds of blood cells are involved by removing the involved blood cells. As a cytapheresis therapy, only leukocytes apheresis has been clinically available in Japan for patients with either fulminant, severe or refractory ulcerative colitis, or rheumatoid arthritis refractory to the conventional drug therapy. Leukocytes such as granulocyte, lymphocyte and monocyte are removed by an either adhesive or centrifugal separation in the extracorporeal blood circuit. Adverse events might occur in the cytapheresis therapy by the load of extracorporeal blood circuit, the interaction between the blood and the biomaterial and/or adverse effects of an anti-coagulative drug. Cytapheresis is considered a rather safe therapy, because the incidence is low and the extent is slight of the adverse events in general. Unforeseen anaphylactic reaction to the biomaterial and/or the anti-coagulative drug might rarely develop, and it should be cautioned. Allergic reaction should be also cautioned when the cytapheresis is applied to a patient with ulcerative colitis who is not taking steroid or taking a low dose steroid, because the allergic reaction might be masked by the anti-allergic effect of the steroid as long as the patient takes a large dose of steroids.