TREATMENT-FREE REMISSION IN SEVERE SYSTEMIC LUPUS-ERYTHEMATOSUS FOLLOWING SYNCHRONIZATION OF PLASMAPHERESIS WITH SUBSEQUENT PULSE CYCLOPHOSPHAMIDE

Objective. To investigate the effect of an intensified treatment proto col synchronizing plasmapheresis with subsequent pulse cyclophosphamid e for severe systemic lupus erythematosus (SLE). Methods. A protocol o f plasmapheresis (3 x 60 ml/kg) and subsequent high-dose pulse cycloph osphamide (36 mg/kg) followed by 6 months of peroral immunosuppression was used to treat 14 patients with severe SLE. Results. Rapid improve ment was achieved in all patients. Immunosuppressants, including corti costeroids, were withdrawn at month 6 in 12 patients. Eight patients c ontinued without treatment for a mean observation period of 5.6 years (46-91 months). Conclusion. The results demonstrate that treatment-fre e clinical remission can be achieved in some patients with severe SLE.