White blood cells (also known as leukocytes) release a number of inflammatory substances that can cause inflammation in the lining of the bowel in people with IBD. Adacolumn involves taking blood from the body, passing the blood through the Adacolumn device to remove specific white blood cells called granulocytes, monocytes and macrophages, and then returning the blood to the body.
The Adacolumn device consists of a plastic cylinder with small beads of cellulose acetate (a type of plastic) inside it. As blood passes through the plastic tube, the white blood cells are selectively removed by the small beads of cellulose acetate. Reducing the number of these white blood cells in the blood means that there are fewer white blood cells available to move to the bowel wall and fuel inflammation.
Adacolumn treatment is usually given as an outpatient or in a day clinic. Blood is taken from a vein in one arm by inserting a cannula or needle into the vein. The blood is pumped slowly through the Adacolumn where some leukocytes are selectively removed. After passing through the Adacolumn, blood is returned to the body through a vein in the opposite arm.
A drug called heparin (which thins the blood) is given during the treatment in order to make the blood slightly thinner to avoid clogging up the Adacolumn.
Each treatment session with Adacolumn lasts for about one hour. It may take place once weekly for five weeks, although the doctor may decide to use a different treatment regime. As with other IBD therapies, the outcome of the treatment is usually evaluated twelve weeks after starting treatment.
Adacolumn works in a different way to drug treatment, so has few side effects. The most common side effects reported are headaches, dizziness and flushing of the cheeks.
This treatment is more commonly used in patients with Ulcerative Colitis (UC), as currently there has been more research into its effectiveness in UC than in Crohn’s Disease patients. Adacolumn is only available in select hospitals in the UK at present. Some studies have found it to be effective in bringing about remission, but more research is needed in this area.
