[Treatment of multiple sclerosis with lymphocytapheresis using a leukocyte adsorption column]

Twenty four patients with multiple sclerosis and four with retrobulbar neuritis were treated with lymphocytapheresis using leukocyte adsorption column. Although intravenous pulsed methylpredonine therapy followed by oral prednisolone therapy was used to treat these patients, they still fail to respond to treatment. Lymphocytapheresis was carried using a "Cellsorba" leukocyte adsorption column (Asahi Medical Co., Tokyo). About 3000 ml of whole blood was treated with the anticoagulant nafamostat mesilate and passed through the column. Eight of the 24 patients who underwent lymphocytapheresis therapy showed marked to moderate improvement. Prior to treat with lymphocytapheresis, their EDSS grades varied 3.0 to 8.5. Within 4-12 hours after therapy each of the eight patients showed EDSS grade improvement of 2 or more steps. Although about 50% of all lymphocytes were removed by lymphocytapheresis, Tal-positive activated T cells were removed more efficiently. None of the patients experienced any side effects following lymphocytapheresis. Treatment efficacy seems to be correlated with the removal of certain pathologically-activated lymphocytes, in particular, Tal-positive T cells.