Leukapheresis and Multiple Sclerosis?

Q:  Here's a question for Dr. Kinkel. Do you think that leukapheresis could be helpful to remove the T-cells accumulated in blood during Tysabri treatment, and perhaps prevent rebound relapses? I have just seen some reports of its use in Crohn's, and I thought about similarities between the two diseases. Thanks!!! Ana

A:  Now that is one great idea that I never considered. For those of you who do not know, leukocytapheresis is a technique used to selectively remove white blood cells from the circulation and return the rest of your blood cell types and plasma back to the patient. Blood is removed in the usual manner and filtered to selectively remove either all the white blood cells or a subset of white blood cells by selective absorbance. Leukocytapheresis has been used to treat inflammatory bowel disease for more than a decade but has not been applied to MS treatment. The person must undergo treatment once a week for up to several months with each treatment requiring up to 3 hours. The real question in my mind is whether this would be an acceptable approach to prevent Tysabri withdrawal relapses. Definitely something to look into. Thanks again for the idea. 

- Dr. Kinkel