Therapeutic apheresis in hematological and oncological diseases

Grima, Kathleen M.

doi:10.1002/(sici)1098-1101(2000)15:1/2<28::aid-jca4>3.0.co;2-n

Cited by 58 publications

(35 citation statements)

References 189 publications

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“…Plasmapheresis is also effective [16,[28][29][30][31][32][33][34][35]. However, when a patient is bleeding, as is frequently the case with PTP, a strategy for immediately improving the platelet count is invaluable.…”

Section: Discussionmentioning

confidence: 99%

“…IVIg is considered first-line therapy, with one or two doses (0.4 mg/kg) resulting in improved platelet counts within a few days [21,23,24,26]. Plasmapheresis is an important component of therapy Contract grant sponsor: NIH/NCI; Contract grant number: T32-CA-009679; Contract grant sponsor: NIH/NHLBI; Contract grant number: HL-54500 [16,[28][29][30][31][32][33][34][35], but it may be second to IVIg because of its relative unavailability and the risk of necessitating an invasive procedure [34]. High-dose methylprednisolone is of uncertain efficacy [24,36].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of HPA‐1a (Pl^A1)‐negative platelets in a patient with post‐transfusion purpura

Loren

Abrams

2004

American J Hematol

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Post-transfusion purpura (PTP) is a rare form of alloimmune thrombocytopenia that is selflimited but which carries a 10-15% mortality related to fatal hemorrhage. Immunomodulatory therapies such as plasmapheresis and intravenous immunoglobulin G (IVIg) can shorten the duration of thrombocytopenia. However, in a bleeding patient with PTP, more urgent therapy may be required. Textbooks of hematology [1][2][3] as well as reports in the literature [4,5] suggest that patients do not respond to platelet transfusions. We report a case of PTP in a patient homozygous for HPA-1b who suffered an intracranial hemorrhage. The patient was treated with IVIg and plasmapheresis. Because of her life-threatening bleeding, we also transfused the patient with HPA-1a-negative platelets. These transfusions consistently resulted in transient improvements in her platelet counts and may have limited the degree of intracranial bleeding. Our experience suggests that transfusion of platelets that lack the offending epitope in patients with PTP may be efficacious. Am.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of HPA‐1a (Pl^A1)‐negative platelets in a patient with post‐transfusion purpura

Loren

Abrams

2004

American J Hematol

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“…Emergent leukapheresis is indicated for leukostasis complications in patients with AML and a WBC count >50 000/µL (Table 2) [14,55,80,81]. The rationale is to remove a critical number of activated blast cells to reduce hyperviscosity, restore tissue perfusion, and minimize or prevent ischemic tissue injury.…”

Section: Hyperleukocytosis and Leukostasis Associated With Acute Leukmentioning

confidence: 99%

“…The treatment of choice for idiopathic TTP is plasma exchange [14][15][16][17][18]. Because patients with TTP and neurologic dysfunction can develop life-threatening complications without warning, apheresis (or, if not immediately available, plasma infusion therapy) should be performed emergently ( Table 2).…”

mentioning

confidence: 99%

“…These include increasing the frequency or volume of daily exchange (eg, to 2 plasma volume exchanges), using cryosupernatant plasma as the replacement fluid, and adding adjunctive immunomodulatory therapies such as intravenous immunoglobulin (IVIg), anti-B-cell antibody therapy (ie, rituximab), or staphylococcal protein A immunoabsorption treatment [14,17,[25][26][27]. Cryosupernatant plasma, which contains reduced levels of VWF, may salvage up to half of the patients who fail to respond to FFP replacement [26].…”

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confidence: 99%

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Use of Cellular and Plasma Apheresis in the Critically Ill Patient: Part II: Clinical Indications and Applications

Linenberger

Price

2005

J Intensive Care Med

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Apheresis is the process of separating the blood and removing or manipulating a cellular or plasma component for therapeutic benefit. Such procedures may be indicated in the critical care setting as primary or adjunctive therapy for certain hematologic, neurologic, renal, and autoimmune/rheumatologic disorders. In part I of this series, the technical aspects of apheresis were described and the physiologic rationale and clinical considerations were discussed. This review highlights the pathophysiologic basis, specific clinical indications, and treatment parameters for disorders that more commonly require management in the intensive care unit. The choice of plasma or cellular apheresis in these cases is guided by well-accepted, evidence-based clinical treatment guidelines. For some disorders, such as liver failure, severe sepsis, and multiple-organ dysfunction syndrome, apheresis treatment approaches remain experimental. Ongoing studies are investigating the potential utility of conventional plasma exchange, ex vivo plasma manipulation, and newer technologies for these and other disorders in severely ill patients.

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Serum hyperviscosity syndrome responding to therapeutic plasmapheresis in a patient with primary Sjögren's syndrome

Simón

Lazo‐Langner

Duarte‐Rojo

et al. 2002

J of Clinical Apheresis

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Hyperviscosity syndrome is a disorder first described in patients with Waldenström's macroglobulinemia and is not commonly seen in rheumatic diseases. Its association with Sjögren's syndrome is very rare and it has been reported in very few patients. We report the case of a patient with primary Sjögren's syndrome presenting as hyperviscosity syndrome who was successfully treated with therapeutic plasma exchange.

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Therapeutic apheresis in hematological and oncological diseases

Cited by 58 publications

References 189 publications

Efficacy of HPA‐1a (Pl^A1)‐negative platelets in a patient with post‐transfusion purpura

Efficacy of HPA‐1a (Pl^A1)‐negative platelets in a patient with post‐transfusion purpura

Use of Cellular and Plasma Apheresis in the Critically Ill Patient: Part II: Clinical Indications and Applications

Serum hyperviscosity syndrome responding to therapeutic plasmapheresis in a patient with primary Sjögren's syndrome

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Therapeutic apheresis in hematological and oncological diseases

Cited by 58 publications

References 189 publications

Efficacy of HPA‐1a (PlA1)‐negative platelets in a patient with post‐transfusion purpura

Efficacy of HPA‐1a (PlA1)‐negative platelets in a patient with post‐transfusion purpura

Use of Cellular and Plasma Apheresis in the Critically Ill Patient: Part II: Clinical Indications and Applications

Serum hyperviscosity syndrome responding to therapeutic plasmapheresis in a patient with primary Sjögren's syndrome

Contact Info

Product

Resources

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Efficacy of HPA‐1a (Pl^A1)‐negative platelets in a patient with post‐transfusion purpura

Efficacy of HPA‐1a (Pl^A1)‐negative platelets in a patient with post‐transfusion purpura