Scientific corner

Extracorporeal granulocytapheresis for cancer and rheumatoid arthritis

Motoki Yonekawa Akio KawamuraTakashi KomaiTetsuzo AgishiMasakazu Adachi§ ,

In cancer and rheumatoid arthritis, granulocytosis is often observed and indicates the progress of disease. We developed a granulocytapheresis system to permit granulocyte reduction. Cellulose acetate was found to be a selective and effective adsorbent. In an in vivo study using an acetate bead column, 9.2 × 108 leukocytes were collected. Initially, granulocytapheresis was applied to terminal patients or those with stage IV cancer. Pain, cough and bloody sputum were reduced in spite of no decrease in the tumor size. Granulocytapheresis appears to prevent inflammatory damage in or around the tumor site. This granulocyte reduction technique was also applied to patients with rheumatoid arthritis. The Lansbury index markedly improved after treatment. As cytokines and adhesion molecules might contribute to symptoms, granulocytapheresis may be useful in improving the “Quality of Life” in these diseases.

Scientific corner

Granulocytapheresis as a possible cancer treatment

T Tabuchi 1H UbukataS SatoI NakataY GotoY WatanabeT HashimotoT MizutaM AdachiT Soma, Anticancer Res
. May-Jun 1995;15(3):985-90.

We assessed the effect of granulocyte apheresis in patients exhibiting increased granulocyte-to-lymphocyte ratio in order to overcome granulocytosis occurring in the terminal stages of malignancies. 17 patients with post-operative recurrent metastatic tumors including 6 gastric, 3 colonic, 2 rectal, 1 esophageal and 5 breast cancers were selected. The granulocytapheresis was performed by extracorporeal vein-to-vein circulation equipped with an apheresis column filled with cellulose acetate beads. Each week the patients underwent one or two sessions of treatment that lasted 30 to 50 minutes per session at a flow rate of 30 to 50 ml/min. 15 sessions formed 1 therapeutic cycle. The effect of granulocytapheresis resulted in partial response (PR) in 4 cases, no change (NC) in 7 cases and partial disease (PD) in 6 cases. The performance status showed 30% remission. None of the patients exhibited significant side effects. Since the treatment demonstrated anti-tumor effects, granulocytapheresis may be applied during combined cancer treatments.

Scientific corner

Extracorporeal Immunotherapy for Terminal-stage Cancer Patients by Using Cellulose Acetate Beads

K. Kukita,M. Yonekawa, H. Hirai,and M. Adachi A. Ikeda,M. Takahashi,J.Meguro, A.Kawamura, T. Mizuta, Jpn JApheresis13(2):148-149,1994

Immunological changes could be affected by this granulocyte/lymphocyte regulation system, but fixed tendencies were not observed within immunological parameters. Responses to this treatment changed on a case-by-case basis, Despite the improvement in subjective symptoms, tumor reduction was not observed. In addition to these immunological changes it has been suggested that this treatment may also have a positive effect on blood viscosity,

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