Relevance of the Processed Blood Volume per Granulocyte and Monocyte Apheresis Session to its Clinical Efficacy in Patients With Ulcerative Colitis
Granulocyte/monocyte adsorption (GMA) has been introduced as an adjunct intervention for active ulcerative colitis (UC) patients. The processed blood volume (PV) per GMA session is an important factor for its efficacy because depletion of elevated/activated myeloid leukocytes is its main action. Hit...
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| Veröffentlicht in: | Therapeutic apheresis and dialysis 2011-08, Vol.15 (4), p.360-366 |
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| creator | Kikuyama, Risa Fukunaga, Ken Kawai, Mikio Yokoyama, Yoko Kamikozuru, Koji Hida, Nobuyuki Ohda, Yoshio Takeda, Naohisa Yoshida, Koji Iimuro, Masaki Kato, Kyoichi Kono, Tomoaki Nogami, Koji Nagase, Kazuko Nakamura, Shiro Takei, Yoshiyuki Miwa, Hiroto Matsumoto, Takayuki |
| description | Granulocyte/monocyte adsorption (GMA) has been introduced as an adjunct intervention for active ulcerative colitis (UC) patients. The processed blood volume (PV) per GMA session is an important factor for its efficacy because depletion of elevated/activated myeloid leukocytes is its main action. Hitherto, this aspect of GMA has been largely ignored. Thirty‐three patients were enrolled for remission induction therapy with five weekly GMA sessions at a standard PV of 1800 mL, regardless of patients' bodyweight (BW). The patients were divided into three groups: high (H)BW (≥65 kg, n = 11), 50 kg ≤ medium (M)BW |
| doi_str_mv | 10.1111/j.1744-9987.2011.00968.x |
| format | Article |
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The processed blood volume (PV) per GMA session is an important factor for its efficacy because depletion of elevated/activated myeloid leukocytes is its main action. Hitherto, this aspect of GMA has been largely ignored. Thirty‐three patients were enrolled for remission induction therapy with five weekly GMA sessions at a standard PV of 1800 mL, regardless of patients' bodyweight (BW). The patients were divided into three groups: high (H)BW (≥65 kg, n = 11), 50 kg ≤ medium (M)BW < 65 kg (n = 12), and low (L)BW (≤50 kg, n = 10). UC clinical activity index (CAI) was according to Lichtiger, and the clinical efficacies were evaluated at both one week post 3rd GMA (Week 4) and one week post 5th GMA (Week 6). The average BW was 70.9 ± 6.2 kg in HBW, 55.8 ± 4.5 kg in MBW, and 46.8 ± 1.2 kg in LBW, indicating the mean PV/BW in the three groups being 25.6 ± 2.12, 32.5 ± 2.50, and 38.7 ± 1.0 (mL/kg, P < 0.05), respectively. The LBW group consisted of female patients only. Significant improvements of CAI were seen before treatment at either Week 4 or Week 6 in all groups. A significantly higher remission rate was achieved in the LBW (80.0%) vs. MBW (33.3%) or HBW (27.3%) at Week 6 (P < 0.03). According to this GMA evaluation, the lower‐limit of optimum PV/kg should be higher than 38.7 mL/kg for its potential clinical efficacy to be significantly greater than the routine GMA method. Additional BW‐oriented GMA studies in larger and gender controlled cohorts of patients should strengthen our findings.</description><identifier>ISSN: 1744-9979</identifier><identifier>EISSN: 1744-9987</identifier><identifier>DOI: 10.1111/j.1744-9987.2011.00968.x</identifier><identifier>PMID: 21884470</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Adsorption ; Adsorptive granulocyte/monocyte apheresis ; Adult ; Blood Component Removal - methods ; Blood Volume ; Body Weight ; Bodyweight ; Colitis, Ulcerative - physiopathology ; Colitis, Ulcerative - therapy ; Female ; Granulocytes ; Humans ; Inflammatory bowel diseases ; Male ; Middle Aged ; Monocytes ; Processed blood volume ; Remission Induction - methods ; Retrospective Studies ; Treatment Outcome ; Ulcerative colitis ; Young Adult</subject><ispartof>Therapeutic apheresis and dialysis, 2011-08, Vol.15 (4), p.360-366</ispartof><rights>2011 The Authors. Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis</rights><rights>2011 The Authors. Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4298-2db339f665aad2b6fe6482d1f85308c3f9c5bbfcb1264eaf66059d348aa6f0ca3</citedby><cites>FETCH-LOGICAL-c4298-2db339f665aad2b6fe6482d1f85308c3f9c5bbfcb1264eaf66059d348aa6f0ca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1744-9987.2011.00968.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1744-9987.2011.00968.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21884470$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kikuyama, Risa</creatorcontrib><creatorcontrib>Fukunaga, Ken</creatorcontrib><creatorcontrib>Kawai, Mikio</creatorcontrib><creatorcontrib>Yokoyama, Yoko</creatorcontrib><creatorcontrib>Kamikozuru, Koji</creatorcontrib><creatorcontrib>Hida, Nobuyuki</creatorcontrib><creatorcontrib>Ohda, Yoshio</creatorcontrib><creatorcontrib>Takeda, Naohisa</creatorcontrib><creatorcontrib>Yoshida, Koji</creatorcontrib><creatorcontrib>Iimuro, Masaki</creatorcontrib><creatorcontrib>Kato, Kyoichi</creatorcontrib><creatorcontrib>Kono, Tomoaki</creatorcontrib><creatorcontrib>Nogami, Koji</creatorcontrib><creatorcontrib>Nagase, Kazuko</creatorcontrib><creatorcontrib>Nakamura, Shiro</creatorcontrib><creatorcontrib>Takei, Yoshiyuki</creatorcontrib><creatorcontrib>Miwa, Hiroto</creatorcontrib><creatorcontrib>Matsumoto, Takayuki</creatorcontrib><title>Relevance of the Processed Blood Volume per Granulocyte and Monocyte Apheresis Session to its Clinical Efficacy in Patients With Ulcerative Colitis</title><title>Therapeutic apheresis and dialysis</title><addtitle>Ther Apher Dial</addtitle><description>Granulocyte/monocyte adsorption (GMA) has been introduced as an adjunct intervention for active ulcerative colitis (UC) patients. The processed blood volume (PV) per GMA session is an important factor for its efficacy because depletion of elevated/activated myeloid leukocytes is its main action. Hitherto, this aspect of GMA has been largely ignored. Thirty‐three patients were enrolled for remission induction therapy with five weekly GMA sessions at a standard PV of 1800 mL, regardless of patients' bodyweight (BW). The patients were divided into three groups: high (H)BW (≥65 kg, n = 11), 50 kg ≤ medium (M)BW < 65 kg (n = 12), and low (L)BW (≤50 kg, n = 10). UC clinical activity index (CAI) was according to Lichtiger, and the clinical efficacies were evaluated at both one week post 3rd GMA (Week 4) and one week post 5th GMA (Week 6). The average BW was 70.9 ± 6.2 kg in HBW, 55.8 ± 4.5 kg in MBW, and 46.8 ± 1.2 kg in LBW, indicating the mean PV/BW in the three groups being 25.6 ± 2.12, 32.5 ± 2.50, and 38.7 ± 1.0 (mL/kg, P < 0.05), respectively. The LBW group consisted of female patients only. Significant improvements of CAI were seen before treatment at either Week 4 or Week 6 in all groups. A significantly higher remission rate was achieved in the LBW (80.0%) vs. MBW (33.3%) or HBW (27.3%) at Week 6 (P < 0.03). According to this GMA evaluation, the lower‐limit of optimum PV/kg should be higher than 38.7 mL/kg for its potential clinical efficacy to be significantly greater than the routine GMA method. Additional BW‐oriented GMA studies in larger and gender controlled cohorts of patients should strengthen our findings.</description><subject>Adsorption</subject><subject>Adsorptive granulocyte/monocyte apheresis</subject><subject>Adult</subject><subject>Blood Component Removal - methods</subject><subject>Blood Volume</subject><subject>Body Weight</subject><subject>Bodyweight</subject><subject>Colitis, Ulcerative - physiopathology</subject><subject>Colitis, Ulcerative - therapy</subject><subject>Female</subject><subject>Granulocytes</subject><subject>Humans</subject><subject>Inflammatory bowel diseases</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monocytes</subject><subject>Processed blood volume</subject><subject>Remission Induction - methods</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Ulcerative colitis</subject><subject>Young Adult</subject><issn>1744-9979</issn><issn>1744-9987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1vEzEQhi0EoqXwF5BvnHbxx354JS4hKgGplKi0DTfL6x0rDs46tXdL8jv4wzhsyZm5zHjmfcbSvAhhSnKa4v0mp3VRZE0j6pwRSnNCmkrk-2fo_DR4fqrr5gy9inFDCGMF5y_RGaNCFEVNztHvG3DwqHoN2Bs8rAEvg9cQI3T4o_O-w_fejVvAOwh4EVQ_Oq8PA2DVd_ir76fHbLeGANFG_D2h1vd48NgOEc-d7a1WDl8ak7I-YNvjpRos9Gm6ssMa3zkNIXUeAc-9s4ONr9ELo1yEN0_5At19urydf86uvi2-zGdXmS5YIzLWtZw3pqpKpTrWVgaqQrCOGlFyIjQ3jS7b1uiWsqoAlYSkbDpeCKUqQ7TiF-jdtHcX_MMIcZBbGzU4p3rwY5RC1CUpWUOTUkxKHXyMAYzcBbtV4SApkUdH5EYejy2Ph5dHR-RfR-Q-oW-fPhnbLXQn8J8FSfBhEvyyDg7_vVjezpapSHg24TYOsD_hKvyUVc3rUq6uF3L1g99U1_dMCv4HHkSr-w</recordid><startdate>201108</startdate><enddate>201108</enddate><creator>Kikuyama, Risa</creator><creator>Fukunaga, Ken</creator><creator>Kawai, Mikio</creator><creator>Yokoyama, Yoko</creator><creator>Kamikozuru, Koji</creator><creator>Hida, Nobuyuki</creator><creator>Ohda, Yoshio</creator><creator>Takeda, Naohisa</creator><creator>Yoshida, Koji</creator><creator>Iimuro, Masaki</creator><creator>Kato, Kyoichi</creator><creator>Kono, Tomoaki</creator><creator>Nogami, Koji</creator><creator>Nagase, Kazuko</creator><creator>Nakamura, Shiro</creator><creator>Takei, Yoshiyuki</creator><creator>Miwa, Hiroto</creator><creator>Matsumoto, Takayuki</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201108</creationdate><title>Relevance of the Processed Blood Volume per Granulocyte and Monocyte Apheresis Session to its Clinical Efficacy in Patients With Ulcerative Colitis</title><author>Kikuyama, Risa ; Fukunaga, Ken ; Kawai, Mikio ; Yokoyama, Yoko ; Kamikozuru, Koji ; Hida, Nobuyuki ; Ohda, Yoshio ; Takeda, Naohisa ; Yoshida, Koji ; Iimuro, Masaki ; Kato, Kyoichi ; Kono, Tomoaki ; Nogami, Koji ; Nagase, Kazuko ; Nakamura, Shiro ; Takei, Yoshiyuki ; Miwa, Hiroto ; Matsumoto, Takayuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4298-2db339f665aad2b6fe6482d1f85308c3f9c5bbfcb1264eaf66059d348aa6f0ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adsorption</topic><topic>Adsorptive granulocyte/monocyte apheresis</topic><topic>Adult</topic><topic>Blood Component Removal - methods</topic><topic>Blood Volume</topic><topic>Body Weight</topic><topic>Bodyweight</topic><topic>Colitis, Ulcerative - physiopathology</topic><topic>Colitis, Ulcerative - therapy</topic><topic>Female</topic><topic>Granulocytes</topic><topic>Humans</topic><topic>Inflammatory bowel diseases</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Monocytes</topic><topic>Processed blood volume</topic><topic>Remission Induction - methods</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Ulcerative colitis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kikuyama, Risa</creatorcontrib><creatorcontrib>Fukunaga, Ken</creatorcontrib><creatorcontrib>Kawai, Mikio</creatorcontrib><creatorcontrib>Yokoyama, Yoko</creatorcontrib><creatorcontrib>Kamikozuru, Koji</creatorcontrib><creatorcontrib>Hida, Nobuyuki</creatorcontrib><creatorcontrib>Ohda, Yoshio</creatorcontrib><creatorcontrib>Takeda, Naohisa</creatorcontrib><creatorcontrib>Yoshida, Koji</creatorcontrib><creatorcontrib>Iimuro, Masaki</creatorcontrib><creatorcontrib>Kato, Kyoichi</creatorcontrib><creatorcontrib>Kono, Tomoaki</creatorcontrib><creatorcontrib>Nogami, Koji</creatorcontrib><creatorcontrib>Nagase, Kazuko</creatorcontrib><creatorcontrib>Nakamura, Shiro</creatorcontrib><creatorcontrib>Takei, Yoshiyuki</creatorcontrib><creatorcontrib>Miwa, Hiroto</creatorcontrib><creatorcontrib>Matsumoto, Takayuki</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Therapeutic apheresis and dialysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kikuyama, Risa</au><au>Fukunaga, Ken</au><au>Kawai, Mikio</au><au>Yokoyama, Yoko</au><au>Kamikozuru, Koji</au><au>Hida, Nobuyuki</au><au>Ohda, Yoshio</au><au>Takeda, Naohisa</au><au>Yoshida, Koji</au><au>Iimuro, Masaki</au><au>Kato, Kyoichi</au><au>Kono, Tomoaki</au><au>Nogami, Koji</au><au>Nagase, Kazuko</au><au>Nakamura, Shiro</au><au>Takei, Yoshiyuki</au><au>Miwa, Hiroto</au><au>Matsumoto, Takayuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relevance of the Processed Blood Volume per Granulocyte and Monocyte Apheresis Session to its Clinical Efficacy in Patients With Ulcerative Colitis</atitle><jtitle>Therapeutic apheresis and dialysis</jtitle><addtitle>Ther Apher Dial</addtitle><date>2011-08</date><risdate>2011</risdate><volume>15</volume><issue>4</issue><spage>360</spage><epage>366</epage><pages>360-366</pages><issn>1744-9979</issn><eissn>1744-9987</eissn><abstract>Granulocyte/monocyte adsorption (GMA) has been introduced as an adjunct intervention for active ulcerative colitis (UC) patients. The processed blood volume (PV) per GMA session is an important factor for its efficacy because depletion of elevated/activated myeloid leukocytes is its main action. Hitherto, this aspect of GMA has been largely ignored. Thirty‐three patients were enrolled for remission induction therapy with five weekly GMA sessions at a standard PV of 1800 mL, regardless of patients' bodyweight (BW). The patients were divided into three groups: high (H)BW (≥65 kg, n = 11), 50 kg ≤ medium (M)BW < 65 kg (n = 12), and low (L)BW (≤50 kg, n = 10). UC clinical activity index (CAI) was according to Lichtiger, and the clinical efficacies were evaluated at both one week post 3rd GMA (Week 4) and one week post 5th GMA (Week 6). The average BW was 70.9 ± 6.2 kg in HBW, 55.8 ± 4.5 kg in MBW, and 46.8 ± 1.2 kg in LBW, indicating the mean PV/BW in the three groups being 25.6 ± 2.12, 32.5 ± 2.50, and 38.7 ± 1.0 (mL/kg, P < 0.05), respectively. The LBW group consisted of female patients only. Significant improvements of CAI were seen before treatment at either Week 4 or Week 6 in all groups. A significantly higher remission rate was achieved in the LBW (80.0%) vs. MBW (33.3%) or HBW (27.3%) at Week 6 (P < 0.03). According to this GMA evaluation, the lower‐limit of optimum PV/kg should be higher than 38.7 mL/kg for its potential clinical efficacy to be significantly greater than the routine GMA method. Additional BW‐oriented GMA studies in larger and gender controlled cohorts of patients should strengthen our findings.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>21884470</pmid><doi>10.1111/j.1744-9987.2011.00968.x</doi><tpages>7</tpages></addata></record> |
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| subjects | Adsorption Adsorptive granulocyte/monocyte apheresis Adult Blood Component Removal - methods Blood Volume Body Weight Bodyweight Colitis, Ulcerative - physiopathology Colitis, Ulcerative - therapy Female Granulocytes Humans Inflammatory bowel diseases Male Middle Aged Monocytes Processed blood volume Remission Induction - methods Retrospective Studies Treatment Outcome Ulcerative colitis Young Adult |
| title | Relevance of the Processed Blood Volume per Granulocyte and Monocyte Apheresis Session to its Clinical Efficacy in Patients With Ulcerative Colitis |
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