Immunoadsorption apheresis in patients with immune-mediated diseases: A single center experience

Abstract

Plasmapheresis is an alternative treatment modality in severe or therapy-resistant forms of immune-mediated diseases. In general, immunoadsorption is a modified form of plasmapheresis. The primary advantage of immunoadsorption to plasmapheresis is that it does not necessitate any fluid substitution and thus avoids the risk of allergic reactions and transmission of infections. In this study, we report our clinical experience on 11 patients (5 females, 6 males) with severe or refractory immune-mediated diseases of various etiology. Patients had undergone to immunoadsorption apheresis procedure in which immunoglobulins were selectively removed from the patients plasma by columns coated with tryptophan as a ligand. A median of 4 (range 1-5) procedures for each patient (total 37) were performed to eleven patients without significant adverse effects. Clinical and/or laboratory responses were observed in seven patients. Immunoadsorption caused significant decreases in plasma levels of immunoglobulins. In clinically active or refractory immune-mediated diseases immunoadsorption apheresis seems to be an effective and safe form of treatment with or without immunosuppressive therapy. Further studies are needed to evaluate the cost-effectiveness of this therapy.