新たな治療選択肢として : クローン病に対する血球成分除去療法(LCAPを中心にして)(<特集>炎症性腸疾患に対するアフェレシスの新展開)

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  • Cytapheresis Especially LCAP for Crohn's Disease as a New Therapeutic Option

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In a prospective multicenter pilot study, we have studied the effect and safety of the addition of leukocytapheresis (LCAP) to on-going drug therapy in refractory Crohn's disease (CD) patients who were not responding to the treatment with salicylic acids and elemental diet or parenteral nutrition for more than 2 weeks but steroid and immune suppressants were not used during the study. Facilities that were familiar with cytapheresis technique for ulcerative colitis were selected. A total of 17 patients were enrolled. More than 7 sessions of LCAP were completed for all patients safely. Results: Effectiveness evaluated by CDAI was 58.8% (10/17; 4 excellent, 6 moderate improvement, 6 no change, and 1 deterioration), 35.2% (6/17; excellent 1, moderately improvement 5, no change 7 and 4 deterioration) when it was evaluated by both CDAI and endoscopic findings. It revealed that the improvement in CDAI shown in LCAP treatment did not achieve mucosal healing, though the 8 weeks following period might be short. There were no severe adverse effects. Usefulness of LCAP added to the on-going drug therapy, which was estimated by the effectiveness, safety, and steroid elimination, is thought to be large.

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