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Granulocyte and monocyte/macrophage apheresis in paediatric patients with ulcerative colitis: a case series in Spain
1Unit for Integral Care of Paediatric Inflammatory Bowel Disease, Gastroenterology, Hepatology and Nutrition Department, Hospital Sant Joan de Déu, Barcelona, Spain.
Insights
Adsorptive granulocyte, monocyte/macrophage apheresis (GMA) offers a safe and effective treatment for paediatric ulcerative colitis. This therapy helps manage inflammation and reduces reliance on corticosteroids and anti-TNF agents in children.
Area of Science:
- Pediatric Gastroenterology
- Immunomodulatory Therapies
- Inflammatory Bowel Disease
Background:
- Paediatric ulcerative colitis (UC) presents challenges including malnutrition and growth issues.
- Current treatments like corticosteroids and anti-TNF agents have potential adverse events in children.
Observation:
- Adsorptive granulocyte, monocyte/macrophage apheresis (GMA) utilizes Adacolumn® to mitigate intestinal inflammation.
- GMA works through diverse immunomodulatory mechanisms.
Findings:
- This case series demonstrates the safety and efficacy of GMA in paediatric UC patients.
- GMA was effective in various scenarios: active UC, steroid reduction, managing loss of response to anti-TNF therapy, and as a bridge therapy.
- GMA served as a substitute for potentially toxic drug treatments.
Implications:
- GMA presents a valuable therapeutic option for paediatric ulcerative colitis.
- It offers an alternative to conventional treatments with significant side effects.
- Further research into GMA's long-term outcomes in children is warranted.
Abstract:
Paediatric ulcerative colitis (UC) can cause malnutrition and growth retardation but its treatment can be limited by the potential adverse events of corticosteroids and anti-TNF agents in children. However, adsorptive granulocyte monocyte/macrophage apheresis (GMA) using Adacolumn® reduces intestinal inflammation through multiple immunomodulatory effects. This case series shows the safety and efficacy of GMA in paediatric UC, illustrating several GMA uses: in chronically active UC, for corticosteroid reduction in steroid-dependent UC, in UC with secondary loss of response to anti-TNF therapy, as bridge therapy in UC with failure of anti-TNF therapy, and to substitute toxic drug treatments.
