Shorter Relapse-Free Period after Leukocyte Removal Therapy in Younger than Older Patients with Ulcerative Colitis

Digestion. 2019;100(4):247-253. doi: 10.1159/000495503. Epub 2018 Dec 12.

Abstract

Background: Leukocyte removal therapy (LRT) is an effective treatment for active ulcerative colitis (UC). The present study was performed to evaluate the relapse-free period after LRT and identify risk factors for relapse.

Methods: In total, 94 patients who underwent first-time LRT for remission of moderate to severe UC from April 2004 to March 2016 were enrolled in the present study. The patients were randomly assigned to one of 2 treatments: leukocytapheresis (LCAP; n = 43) or granulocyte and monocyte/macrophage adsorptive apheresis (GMA; n = 51). The 5-year cumulative relapse-free rate and risk factors for relapse were evaluated.

Results: The therapeutic response rate was 82% for GMA and 70% for LCAP without a statistically significant difference. The 5-year relapse-free rate was 34.7% in the LRT group. The 5-year relapse-free rate in patients aged > 40 years was 49.9%, which was significantly higher than that in patients aged ≤40 years (22.9%, p < 0.01). The relapse-free period was longer in the older than younger patients.

Conclusions: The relapse-free period after LRT was examined in patients with UC, and 34.7% of patients achieved clinical remission within a 5-year period. The risk factor for early relapse after LRT was younger age.

Keywords: Granulocyte and monocyte/macrophage adsorptive apheresis; Leukocytapheresis; Long-term outcome; Remission.

MeSH terms

  • Adult
  • Age Factors
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / immunology
  • Colitis, Ulcerative / therapy*
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Leukapheresis*
  • Leukocytes / immunology*
  • Male
  • Middle Aged
  • Recurrence
  • Remission Induction / methods*
  • Risk Factors
  • Secondary Prevention / methods*
  • Time Factors
  • Treatment Outcome
  • Young Adult