Apheretic “rescue-protocol” designed for treatment of CLL associated life-threatening hemolytic crisis

Balint, Bela; Todorović-Balint, Milena; Ljubenov, Marika; Tarabar, Olivera; Pavlović, Mirjana; Kanjuh, Vladimir

doi:10.1016/j.transci.2014.12.024

Cited by 3 publications

(4 citation statements)

References 7 publications

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“…TAph treatment should be done regularly or always combined with "immunomodulatory" (e.g., immunochemotherapy) and other palliative (drug) therapies. Based upon the criterion of what is the removed blood constituent-with specific "pathogenic factors or substrate"-it is possible to classify the TAph procedures into TPE and therapeutic cytapheresis (TC) [5][6][7][8][9][10][11][12][13][14][15].…”

Section: Apheresis/cytapheresis: a Systematic Overviewmentioning

confidence: 99%

“…The aim of TLs is white blood cell (WBC) count reduction and reverse of the "hyperleukocytosis-leukostasis" syndrome, regression of organomegaly and lymphadenomegaly, and improvement in general clinical status [2,[15][16][17]. TLs represent a useful "cytoreductive" therapy during "leukostasis crisis" when the number of circulating WBC ≥ 150 × 10 9 /L.…”

Section: Apheresis/cytapheresis: a Systematic Overviewmentioning

confidence: 99%

“…Concisely, the goal of our original and innovative "multi-manner" TAph is to offer the possibility of rapid returning from a "life-threatening" (irreversible) emergency-altering simultaneously more than one blood constituent(s)-to the "district" of unbalanced, but reversible clinical condition, with a possibility for recovery of patient's hematological and overall clinical homeostasis [13][14][15].…”

Section: Apheresis/cytapheresis: a Systematic Overviewmentioning

confidence: 99%

“…Generally, the most critical step in TC therapy of patients with different types of "cythemia" (blood cell overproduction) is to define the optimal timing, frequency, as well as the intensity and duration of treatment. The use of TC procedures requires determination of excessive cell category and total cell quantity and to resolve also the predominant cell divisions (including intravascular vs. extravascular portions), as well as to establish and compensate for "peri-apheresis" intensity of novel blood cell production [15][16][17].…”

Section: Therapeutic Thrombocytapheresismentioning

confidence: 99%

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Rapid Cytoreduction by Plateletapheresis in the Treatment of Thrombocythemia

Balint¹,

Pavlović²,

Todorović³

2020

Platelets

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The objective of this chapter is to provide a systematic overview of current knowledge regarding therapeutic apheresis-primarily therapeutic plateletapheresis (TP)-and to summarize evidence-based practical approaches related to cytapheresis treatment of "hyperthrombocytosis" or "extreme thrombocytosis" (ETC). Our results of platelet (Plt) quantitative/qualitative analyses and evaluation of efficacy of apheresis systems/devices-on the basis of Plt removal and in vivo Plt depletion-will be presented. Our preclinical researches confirmed that in Plt concentrates, the initial ratio of discoid shapes was 70%, spherical 20%, and less valuable (dendritic/balloonized) shapes 10%-with morphological score of platelets (MSP = 300-400). After storage, the ratio of discoid and spherical shapes was decreased, while the less valuable ones progressively increased (MSP = 200). Electron microscopy has shown discoid shapes with typical ultrastructural properties. Spherical shapes with reduced electron density and peripheral location of granules/organelles were detected. Also, dendritic shapes with cytoskeletal "rearrangement," membrane system integrity damages, and pseudopodia formations were documented. Our clinical study demonstrated that TP was useful in ETC treatment and should help prevention of "thrombo-hemorrhagic" events-until chemotherapy, antiplatelet drugs, and other medication take effect. During TP treatment, Plt count and morphology/ultrastructure were examined. Plt functions by multiplate analyzer were evaluated. We concluded that intensive TP was an effective, safe, and rapid cytoreductive treatment for ET.

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