Addition of leukocytapheresis to steroid therapy: is it beneficial in recurrence of moderate-to-severe XXXX ?

@entity1 @entity31 @entity617
PURPOSE: In Japan, leukocytapheresis has become an accepted therapy for @entity31 . The purpose of this retrospective study was to determine the efficacy of additional leukocytapheresis in @entity1 with moderate-to-severe recurrence of @entity31 . METHODS: From 1998 to 2002, 35 @entity1 with moderate-to-severe recurrence of @entity31 were treated by intravenous @entity617 only or @entity617 plus leukocytapheresis once per week. Previous clinical features of @entity31 , activity index at four weeks, and subsequent course were compared between @entity1 with leukocytapheresis and those without. RESULTS: Sixteen @entity1 were treated with @entity617 only ( @entity617 group), and 19 @entity1 were treated with @entity617 plus leukocytapheresis (leukocytapheresis group). Previous @entity617 dose (13.6 +/- 10.4 g vs. 7.9 +/- 9.8 g; P < 0.05) was higher in the leukocytapheresis group than the @entity617 group. Clinical response rate at four weeks was not different between the two groups (leukocytapheresis group, 68.4 percent vs. @entity617 group, 75 percent). However, @entity31 activity index at four weeks was significantly higher in the leukocytapheresis group than the @entity617 group (180.5 +/- 44.2 vs. 142.5 +/- 45.3; P < 0.05). During the subsequent clinical course, 15 of 35 @entity1 required proctocolectomy (leukocytapheresis group, 11 @entity1 vs. @entity617 group, 4 @entity1 ). Proctocolectomy rate was significantly different when @entity1 were divided by previous @entity617 dose (P = 0.0029) and @entity31 activity index at four weeks (P = 0.002), but it was not different according to the application of leukocytapheresis. Cox proportional hazards model revealed previous @entity617 dose to be the only independent risk factor for proctocolectomy. CONCLUSIONS: Addition of leukocytapheresis to @entity617 therapy does not seem beneficial in @entity31 @entity1 with moderate-to-severe recurrence.
