Immunoadsorption apheresis and immunosuppressive drug therapy in the treatment of complicated HCV-related cryoglobulinemia

Pietro Manuel Ferraro, Claudia Stefanutti, Antonio Vivenzio, Serafina Di Giacomo, Giancarlo Labbadia, Fabio Mazza, Giovanna D'Alessandri, Cesare Masala

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26 Citations (Scopus)

Abstract

The immunosuppressive drug therapy (IDT) is not always effective to avoid the development of complications in hepatitis C virus-related cryoglobulinemia (HCV-Cr). Removal of cryoglobulins by therapeutic plasmapheresis is currently accepted. In this randomized, parallel group study, 17 male and female patients aged 43-79 years, with complicated HCV-Cr, were submitted for 12 weeks (initial immunosuppressive therapy) to IDT (α-interferon, pegylated-interferon α-2a, cyclophosphamide, methylprednisolone, prednisone, cyclosporine, ribavirin, and melphalan). Then, they were randomly assigned to two parallel groups: A # 9 patients treated by immunoadsorption apheresis (Selesorb®) (IA) plus IDT, and B # 8 patients submitted to IDT only, for further 12 weeks. # 187 IA aphereses were performed. No adverse reactions or complications were observed. A Clinical Score (CS) was adapted from a pre-existing scoring model to evaluate signs and symptoms inherent to the underlying immunologic disorder. The CS was calculated at baseline (CS0), after the initial immunosuppressive therapy (CS1 = 12 weeks) when patients were treated only with IDT, and at the end of the study (24 weeks) in the group A (CSA; IA plus IDT) and B (CSB; IDT only). The score did not change significantly from CS0 to CS1. However, statistically significant differences were observed between CS1 and CSA (P < 0.001), and CSA versus CSB (P = 0.03), respectively. The changes observed were favorable to the patients assigned to the IA plus IDT group (A): in most case relief of symptoms and complications have been obtained. © 2009 Wiley-Liss, Inc.
Original languageEnglish
Pages (from-to)241-246
Number of pages6
JournalJournal of Clinical Apheresis
Volume24
DOIs
Publication statusPublished - 2009

Keywords

  • Adult
  • Aged
  • Blood Component Removal
  • Combined Modality Therapy
  • Cryoglobulinemia
  • Female
  • HCV-related cryoglobulinemia
  • Hematology
  • Hepatitis C
  • Humans
  • Immunoadsorption apheresis
  • Immunosorbent Techniques
  • Immunosuppressive Agents
  • Immunosuppressive drug therapy
  • Male
  • Middle Aged

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