Abstract: Objective To investigate the efficacy of low-dose intravenous cyclophosphamide (IV CTX) in combination with immunoclearance in treatment of systemic lupus erythematosus. Metheds Sixty one SLE patients were analysed. Patients assigned to the low-dose group(33 cases) received 6 to 12 fortnightly IV CTX pulses at a fixed dose of 400mg followed by 6 monthly pulses. Patients assigned to the low-dose IV CTX in combination with immunoclearance received 1 to 3 times of immunoclearance before the treatment of CTX. All patients received the treatment of glucocorticosteroid. The changes of the indexes were observed before and after one year treatment including the symptoms and the levels of WBC, PLT, Hb, serum creatinine, albumin, C3, C4, 24-hour urinary protein, IgG, IgA, IgM, ANA, anti-dsDNA antibody and anti-ENA antibody. Results After a median followup of 1 year, the SLEDAI decreased from 13.73 to 5.44 in the low-dose IV CTX group and from 14.37 to 5.17 in those who received the low-dose IV CTX in combination with immunoclearance. Otherwise seroconversion rate of anti-ENA antibody were 18.2% and 42.9% in the low-dose IV CTX group and the low-dose IV CTX in combination with immunoclearance group. The seroconrersion rate of anti-dsDNA antibody were 39.4% and 85.7% in the low-dose IV CTX group and the low-dose IV CYC in combination with immunoclearance group.There were statistical difference between the two groups. Conclusion The efficacy of low-dose IV CTX in combination with immunoclearance in treatment of SLE achieves significant results than those obtained by low-dose IV CTX regimen.

Key words: Cyclophosphamide, Immunoclearance