Dr. Harbord says the patient’s clinical improvement
was immediate and significant, with hemodynamic stabilization during the
first treatment, followed by enhanced liver function and mental status.
“We were able to demonstrate marked improvement in the patient’s
clinical illness by removing the cytokines, which were responsible for
his hypotension and shock,” Dr. Harbord says. “The dose of pressors,
the day-to-day bloodwork—all of it improved, and we saw a 56 percent
reduction in cytokines over the course of therapy.”
Dr. Harbord says that CytoSorb is nonspecific, removing many elevated
cytokines (both pro- and anti-inflammatory), but he adds that the risks
are not significant and that the risk of not intervening may be greater.
Given the results achieved in this investigational use, he says, cytokine
hemadsorption has potential as a treatment for HLH, a disease with a
mortality rate in excess of 50 percent.
“I think we demonstrated real proof-of-concept benefit for patients
through investigational use,” Dr. Harbord says. “I would not hesitate to
use it again, and I would hope it gives other nephrologists the confidence
to adopt it based on our experience at Mount Sinai.”
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