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

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 10(8) granulocytes, 5.23 x 10(8) monocytes, and 20.5 x 10(8) 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 > or =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.

Leukocytapheresis therapy by extracorporeal circulation using a leukocyte removal filter.

Leukocytapheresis therapy has been used to try to treat such intractable diseases as autoimmune and neurologic diseases, achieving good results. However, a number of problems have been identified in leukocyte removal by thoracic duct drainage or continuous centrifugal separation; namely the high risk, expensive cost, and complicated operation. Asahi Medical Co. has developed an innovative solution for such conventional problems. Its new leukocyte removal filter (Cellsorba) is capable of removing white blood cells by perfusion of whole blood by means of simple extracorporeal circulation. Leukocytapheresis therapy using the Cellsorba column is being confirmed as extremely effective for many inflammatory diseases, as well as in autoimmune and neurologic diseases. This paper outlines information about the Cellsorba column and introduces several reports on therapeutic results.

A new type of blood component collector: plasma separation using gravity without any electrical devices.

A new type of blood component collector (BCC) was developed to divide 450 ml of whole blood into plasma and a red cell concentrate using gravity without electrical devices. This BCC system is composed of one whole blood collection bag, two product collection bags and a plasma separator, which consists of a bundle of hydrophilized polyethylene hollow fibers (0.2 micron pore size). Without rinsing the plasma separator, the whole blood (458.1 +/- 13.5 ml, n = 22) was run through the separator using gravity without a pump. An average of 175.9 ml of plasma was collected within 11 min without hemolysis. In this completely cell-free plasma, the recovery of total protein, albumin, globulin, IgG and IgA was nearly 100%. Prothrombin time and activated partial thromboplastin time were in a normal range and the activity of coagulation factors did not change after the separation. In the red cell concentrate, the recovery of red cells, white cells and platelets was 94.7, 98.4 and 82.7%, respectively. Osmotic fragility of red cells, platelet morphology and functions did not change. These observations suggest that this new type of BCC is useful as a simple, fast and safe component collector.