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2264 pages added, reviewed or updated during the last month (last updated: 21/4/2021)


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leukapharesis for inflammatory bowel disease

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Leukapheresis:

  • involves extracorporeal removal of leukocytes from the blood, either by centrifugation or through an adsorptive system
  • venous blood is removed in a continuous flow, anticoagulated, processed to deplete the leukocytes and returned to the circulation
    • different apheresis systems remove different populations of white blood cells
    • leukapheresis using centrifugation removes a proportion of neutrophils and lymphocytes
      • filter columns, which may contain cellulose acetate beads or a polyester fibre filter, remove a large proportion of granulocytes and monocytes and some also remove lymphocytes
      • exact mode of action of these procedures is unknown.

In ulcerative colitis:

  • in one randomised controlled 74% (29/39) of patients treated with leukapheresis had an ‘excellent’ or ’moderate’ improvement in symptoms, compared with 38% (14/37) of patients treated with highdose steroids (p = 0.005)

In Crohn's disease:

  • a small randomised controlled trial of patients with Crohn’s disease, 100% (12/12) of patients treated with leukapheresis were successfully withdrawn from steroid therapy, compared with 67% (10/15) of patients who were not treated with leukapheresis (p = 0.074)
    • no significant difference between the two groups in disease recurrence at 18-month follow-up

Reference:

  1. NICE (July 2005). Leukapheresis for inflammatory bowel diseas

Last reviewed 01/2018

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