A Randomized Study of On-Line Plasma Perfusion over Protein A-Sepharose and 5-Fluorouracil Chemotherapy in Patients with Metastatic Colorectal Carcinoma

Autor: Faradji, A., Bohbot, A., Damonte, J., Arnaud, J.P., Eber, M., Laustriat, D., Goetz, J., Wiesel, M.L., Follea, G., Piemont, Y., Bergerat, J.P., Cazenave, J.P., Adloff, M., Oberling, F.
Zdroj: International Journal of Artificial Organs; February 1991, Vol. 14 Issue: 2 p109-115, 7p
Abstrakt: To evaluate the safety of on-line plasma perfusion over protein-A sepharose and the therapeutic advantage of combining plasma perfusion (PP) over protein-A sepharose with 5-fluorouracil (5-FU) chemotherapy in patients with metastatic colorectal carcinoma (MCRC), thirty patients were randomized after surgery of primary CRC to receive a combination of 5-FU and PP over protein-A sepharose (group A), or a combination of 5-FU and PP over sepharose (group B), or 5-FU alone (group C). Bi-weekly on-line PP over 200 ml protein-A sepharose gel (group A) or 200 ml sepharose gel (group B) were performed with a Cobe 2997 blood cell separator for a maximum of 19 treatments per patient. 5-FU was given at 1000 mg/m2/d on days 1-5 of a 4-weekly cycle until progression. PP was well tolerated and no severe or life-threatening toxicity was observed. Mild clinical side-effects consisted of fever and chills (36% in group A, 23% in group B). The most common biological effects of PP over protein-A sepharose were significant drops in IgG (66% of pre-PP values), CH50 and C3 (73% of pre-PP values) and a significant generation of C3a and C5a anaphylatoxins. Tumor response rates were 40% for group A, 0% for group B and 20% for group C. The median survival times tended to be longer in group A (17 months) than in group B (10 months) and in group C (9 months). This is the first randomized trial showing some therapeutic advantage in combining PP over protein-A sepharose with conventional chemotherapy in MCRC.
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