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Leukocytapheresis in Pediatric Patients With Ulcerative Colitis.
MedLine Citation:
PMID:  21694533     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: Leukocytapheresis (LCAP) is a nonpharmacologic therapy that has recently been used to treat ulcerative colitis (UC). This multicenter open-label study prospectively assessed the efficacy and safety of LCAP in pediatric patients with UC. PATIENTS AND METHODS:: Twenty-three patients ages 8 to 16 years with moderate (n = 19) to severe (n = 4) steroid-resistant UC were enrolled. One of 2 LCAP columns with different volumes (model EX and the half-volume model EI) was selected, according to body weight. LCAP was performed once per week for 5 consecutive weeks. Clinical and laboratory data were collected at predetermined time points. The primary endpoint was decreased stool frequency/hematochezia score, and secondary endpoints were clinical, laboratory, and endoscopic improvements. RESULTS:: The stool frequency/hematochezia score decreased significantly from 4.5 ± 1.2 before treatment to 1.6 ± 1.9 after the fifth treatment. Clinical parameters, including stool frequency, presence of visible blood, abdominal pain, and body temperature, were significantly improved. Fecal calprotectin decreased significantly. Endoscopic findings evaluated using Matts score also improved (P < 0.01). The steroid dose decreased from 1.1 ± 0.4 mg/kg before treatment to 0.8 ± 0.5 mg/kg after treatment. There were no significant differences in changes between the EX and EI columns. The incidence of adverse effects was 61%, although none was serious. The most common adverse effects were decreased hematocrit and hemoglobin concentration. CONCLUSIONS:: The present study showed that LCAP was well tolerated in children with UC, mostly moderate, and was as effective as in adults. The types of pediatric patients best suited to LCAP remain to be determined.
Authors:
Takeshi Tomomasa; Hitoshi Tajiri; Seiichi Kagimoto; Toshiaki Shimizu; Atsushi Yoden; Kosuke Ushijima; Keiichi Uchida; Hiroaki Kaneko; Daiki Abukawa; Mutsuko Konno; Shun-Ichi Maisawa; Takao Kohsaka; Akio Kobayashi;
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  53     ISSN:  1536-4801     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-6-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  34-39     Citation Subset:  -    
Affiliation:
*Departments of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan †Osaka General Medical Center, Japan ‡Saitama Children's Medical Center, Japan §Juntendo University School of Medicine, Japan ||Osaka Medical College, Japan ¶Kurume University Medical Center, Japan #Departments of Gastroenterology and Pediatric Surgery, Mie University Hospital, Japan **Mirai Children's Clinic, Japan ††Miyagi Children's Hospital, Japan ‡‡Departments of Pediatrics, Sapporo Kosei General Hospital, Japan §§Morioka Children's Hospital, Japan ||||Departments of Pediatrics, Tokyo West Tokushukai Hospital, Japan ¶¶Showa University, Toyosu Clinic, Japan.
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