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Rheumatology 2000; 39: 165-171
© 2000 British Society for Rheumatology

Evaluation of filtration leucocytapheresis for use in the treatment of patients with rheumatoid arthritis

Y. Ueki5, S. Yamasaki, Y. Kanamoto, T. Kawazu, M. Yano, K. Matsumoto, S. Miyake, Y. Tominaga, U. Iwamoto1, J. Suemitsu1, Y. Matsuno1, Y. Sizume2, Y. Takenaka2 and K. Eguchi3

Department of Internal Medicine, Sasebo Chuo Hospital, Sasebo,
1 Asahi Medical Research and Development Laboratory, Oita,
2 Asahi Medical Technical Department, Tokyo and
3 The First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan

Objectives. To evaluate the efficacy of filtration leucocytapheresis (LCP) for rheumatoid arthritis (RA).

Methods. LCP was carried out three times, with 1 week separating each session, in 25 drug-resistant RA patients.

Results. During each session, 96, 98, 61, 84 and 8% of the granulocytes, monocytes, lymphocytes, platelets and erythrocytes, respectively, that entered the LCP filter were removed. The number of granulocytes, monocytes and lymphocytes in the peripheral blood significantly decreased during each session of LCP. However, there was no significant decrease in the number of circulating blood cells during the study period. On average, 110 x 108 granulocytes, 5.23 x 108 monocytes, and 20.5 x 108 lymphocytes were removed during LCP therapy. Assessment of RA before and after LCP showed a substantial and rapid improvement in the tender joints counts, swollen joint counts, and patient's and physician's assessments. No adverse reactions or complications were noted. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels decreased following LCP, although the change in the latter parameter was statistically insignificant. The concentrations of serum albumin, {gamma}-globulin, IgG, IgM, CH50 and rheumatoid factor titres did not change during or after LCP. Careful analysis indicated that 16 of 25 patients with RA showed >=20% improvement following LCP therapy.

Conclusions. Our results suggest that filtration LCP to remove leucocytes from the peripheral blood exerts an immunomodulatory effect in patients with RA.

KEY WORDS: Leucocytapheresis filter, Leucocytapheresis, Rheumatoid arthritis, Immunomodulation

5 Correspondence to: Y. Ueki, Department of Internal Medicine, Sasebo Chuo Hospital, Yamato-cho 15, Sasebo 857-1195, Japan.


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