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Journal of Clinical Apheresis

Luis Palma-Garcia, Victor Velásquez-Rimachi, Armando Pezo-Pezo, Joseph Roig, Julio Perez-Villegas
BACKGROUND: Therapeutic plasma exchange (TPE) is an extracorporeal procedure which consists of removing the patient's plasma and replacing it with an appropriate replacement fluid. Plasma and blood cells are separated by a centrifugation process. Our department has used TPE for several years, and in 2013 we introduced an institutional apheresis protocol. The main objective of this report is to describe the TPE procedures performed between 2013 and 2016 in the Peruvian population. METHODS: We analyzed the technical and clinical aspects of 864 centrifugal TPE procedures as well as the associated complications...
March 14, 2018: Journal of Clinical Apheresis
Oluwatoyosi A Onwuemene, Steven C Grambow, Chetan B Patel, Robert J Mentz, Carmelo A Milano, Joseph G Rogers, Ara D Metjian, Gowthami M Arepally, Thomas L Ortel
INTRODUCTION: Limited data are available describing indications for and outcomes of therapeutic plasma exchange (TPE) in cardiac transplantation. METHODS: In a retrospective study of patients who underwent cardiac transplantation at Duke University Medical Center from 2010 to 2014, we reviewed 3 TPE treatment patterns: a Single TPE procedure within 24 h of transplant; Multiple TPE procedures initiated within 24 h of transplant; and 1 or more TPE procedures beginning >24 h post-transplant...
March 10, 2018: Journal of Clinical Apheresis
Andrew P Norgan, Justin E Juskewitch, Bobbi S Pritt, Jeffrey L Winters
Cytapheresis (removal of cellular blood components) has been employed for treatment of infectious diseases since the 1960s. Techniques have included thrombocytapheresis (buffy coat apheresis) for loiasis, erythrocytapheresis for malaria and babesiosis, and leukocytapheresis for pertussis-associated lymphocytosis. Published data on these applications is largely limited to case level data and small observational studies; as such, recommendations for or against the use of cytapheresis in the treatment of infections have been extrapolated from these limited (and at times flawed) data sets...
February 28, 2018: Journal of Clinical Apheresis
Daniel Putensen, Richard Smith, Linda Pilcher, George Trandafir
BACKGROUND: An increasing demand for human lymphocytes require an efficient, reliable and reproducible lymphocyte process. Here, we compare the Spectra Optia® CMNC protocol with the Optia MNC platform in unmobilised donor lymphocyte collections. PURPOSE: To establish and compare the feasibility, efficiency, and practicability of the two apheresis protocols. METHODS: Data was collected prospectively from 60 non-cytokine stimulate donors who underwent a total of 64 T-cell collection procedures...
February 21, 2018: Journal of Clinical Apheresis
Huy P Pham, Dheeraj Raju, Joseph Schwartz
No abstract text is available yet for this article.
February 15, 2018: Journal of Clinical Apheresis
Christine L H Snozek, Theresa N Kinard, Jill Adamski
This report describes a patient with light chain myeloma and acute renal injury. Serum kappa free light chain (FLC) was extremely elevated, >33,000 mg/dL. Treatment with therapeutic plasma exchange (TPE) started day 2 for biopsy-confirmed cast nephropathy. Bortezomib-containing chemotherapy was initiated on day 5, and hemodialysis for tumor lysis syndrome on day 7. TPE alone decreased kappa FLC >70% by day 5, indicating direct FLC removal was successful in this patient. A total of 25 TPE procedures were performed in a 31-day hospitalization...
February 10, 2018: Journal of Clinical Apheresis
Najeebah A Bade, Victoria S Giffi, Maria R Baer, Ann B Zimrin, Jennie Y Law
BACKGROUND: Human immunodeficiency virus (HIV) infection increases the risk of thrombotic microangiopathy (TMA), but TMA in the setting of HIV infection is not well characterized. The experience with TMA in the setting of HIV infection at the University of Maryland Medical Center was reviewed. STUDY DESIGN AND METHODS: Patients undergoing therapeutic plasma exchange (TPE) for TMA from January 1, 2000 through December 31, 2012 were reviewed. Those with known HIV-positive and -negative status were compared...
January 26, 2018: Journal of Clinical Apheresis
Araci M Sakashita, Andrea T Kondo, Ana Paula H Yokoyama, Sanny M C Lira, Carolina B Bub, Aline M Souza, Andrea N F Cipolletta, Kelen C Alvarez, Nelson Hamerschlak, Jose M Kutner, Carlos S Chiattone
BACKGROUND: Autologous peripheral blood hematopoietic stem cell (PBSC) collection efficiency (CE) is reportedly affected by the patient's blood properties; however, studies to identify factors correlated with CE have shown inconsistent results. Additionally, variables such as stem cell graft granulocyte content and patient age, sex, and underlying disease, may be associated with hematopietic stem cell (HSC) infusion-related adverse reactions. In this study, we evaluated the correlation of preleukapheresis PB granulocyte count and PBSC harvest variables with CD34+ collection yield and efficiency, and thawed HSC infusion side effect occurrence...
January 19, 2018: Journal of Clinical Apheresis
Maiko Takakura, Masaki Shimizu, Mao Mizuta, Natsumi Inoue, Yuko Tasaki, Kazuhide Ohta, Kengo Furuichi, Takashi Wada, Akihiro Yachie
Although rituximab (RTX) is a promising therapeutic agent for treating steroid-resistant nephrotic syndrome (SRNS) resistant to various immunosuppressive agents, some patients have shown resistance to RTX. We report the case of a patient with RTX-resistant nephrotic syndrome and SRNS who was successfully treated with leukocytapheresis (LCAP). After LCAP, there was a significant reduction in proteinuria and in the total number of lymphocytes, T cells, and HLA-DR +- activated T cells. Moreover, the patient became sensitive to steroids and RTX...
January 16, 2018: Journal of Clinical Apheresis
Tina S Ipe, Huy P Pham, Lance A Williams
The 7th edition of the American Society for Apheresis (ASFA) guidelines was composed by an international physicians committee, and includes 14 new diseases, and 2 new indications for diseases described in the former guidelines. Several indications have either changed names or were excluded from this edition. The guidelines are developed after taking into account documented evidence, either supporting or negating use of apheresis technology in the treatment of diseases. Based on this evidence, the committee revises, updates and includes or excludes disease entities/indications in the guidelines...
February 2018: Journal of Clinical Apheresis
Kenneth W Douglas, Maria Gilleece, Patrick Hayden, Hannah Hunter, Peter R E Johnson, Charlotte Kallmeyer, Ram K Malladi, Shankara Paneesha, Rachel Pawson, Michael Quinn, Kavita Raj, Deborah Richardson, Stephen Robinson, Nigel Russell, John Snowden, Anna Sureda, Eleni Tholouli, Kirsty Thomson, Mike Watts, Keith M Wilson
Plerixafor is a CXC chemokine receptor (CXCR4) antagonist that mobilizes stem cells in the peripheral blood. It is indicated (in combination with granulocyte-colony stimulating factor [G-CSF]) to enhance the harvest of adequate quantities of cluster differentiation (CD) 34+ cells for autologous transplantation in patients with lymphoma or multiple myeloma whose cells mobilize poorly. Strategies for use include delayed re-mobilization after a failed mobilization attempt with G-CSF, and rescue or pre-emptive mobilization in patients in whom mobilization with G-CSF is likely to fail...
February 2018: Journal of Clinical Apheresis
Andrea M McGonigle, Aaron A R Tobian, Jennifer L Zink, Karen E King
Thyroid storm is a potentially lethal complication of hyperthyroidism with increased thyroid hormones and exaggerated symptoms of thyrotoxicosis. First-line therapy includes methimazole (MMI) or propylthiouracil (PTU) to block production of thyroid hormones as a bridge toward definitive surgical treatment. Untreated thyroid storm has a mortality rate of up to 30%; this is particularly alarming when patients cannot tolerate or fail pharmacotherapy, especially if they cannot undergo thyroidectomy. Therapeutic plasma exchange (TPE) is an ASFA category III indication for thyroid storm, meaning the optimum role of this therapy is not established, and there are a limited number of cases in the literature...
February 2018: Journal of Clinical Apheresis
Nolan Maloney, Isabella Martin, Zbigniew M Szczepiorkowski, Nancy M Dunbar
Thrombotic thrombocytopenic purpura (TTP) is an acute, life-threatening illness with disseminated platelet-rich thromboses of small vessels that variably presents with the classic clinical "pentad" of microangiopathic hemolytic anemia, thrombocytopenia, fever, altered mental status, and acute kidney injury. Most cases are caused by an acquired autoantibody to ADAMTS13, a metalloproteinase that cleaves large von Willebrand Factor (vWF) multimers. The mainstay of treatment is daily therapeutic plasma exchange (TPE), sometimes with adjunctive pharmacologic immunosuppression...
December 22, 2017: Journal of Clinical Apheresis
Luis F Porrata
In addition to stem cells, T-cells, natural killer cells, dendritic cells, and monocytes are also collected and infused from the autograft in patients undergoing autologous peripheral blood hematopoietic stem cell transplantation. Recent reports have shown that these autograft immune effector cells can affect the clinical outcome postautologous peripheral blood hematopoietic stem cell transplantation. In this article, I will review the clinical impact on the survival of these autograft immune effector cells conferring the concept of autologous graft versus tumor effect...
December 12, 2017: Journal of Clinical Apheresis
Robert M Whittle, Helen Denney, Andrew D Chantry, Arun Alfred, Peter C Taylor
Extracorporeal Photopheresis (ECP) is a cellular immunotherapy frequently used for steroid-refractory graft-versus-host disease (GVHD). Chronic GVHD (cGVHD), response to ECP is associated with survival benefit. The UVAR-XTS(TM) system and the more recently developed CELLEX(TM) device (both Therakos(TM) ) are the mainstay for ECP-delivery in the UK and US. No comparison of treatment outcomes has been reported. We retrospectively compared cGVHD response and steroid reduction and withdrawal in patients treated exclusively over 12 months with either the XTS (n = 51) or CELLEX (n = 50)...
December 2017: Journal of Clinical Apheresis
Alexis R Peedin, Yara A Park, Jay S Raval
INTRODUCTION: Physicians from diverse training backgrounds practice apheresis medicine. Pathology residents' exposure to apheresis may vary depending on which department performs these procedures. Milestones for Apheresis education were published in 2012, but the degree of utilization in residency curriculum development is unknown. This study describes the current state of apheresis education for pathology residents. METHODS: We sent a 15 question electronic survey to 141 pathology programs identified through the American Medical Association Residency and Fellowship Database...
December 2017: Journal of Clinical Apheresis
Ina Lieker, Torsten Slowinski, Lutz Harms, Katrin Hahn, Juliane Klehmet
BACKGROUND: Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare paralyzing inflammatory neuropathy with probably autoimmune origin. While plasma exchange (PE) constitutes a first-line treatment option for CIDP, there is only little known about the efficacy and safety of immunoadsorption (IA), a more selective apheresis procedure with assumed better tolerability. METHODS: In this prospective-randomized pilot trial, patients were randomly assigned to receive 6 sessions of PE (n = 10) or IA (n = 10) treating equal plasma volumes...
December 2017: Journal of Clinical Apheresis
Gerard Cortina, Violeta Ojinaga, Thomas Giner, Magdalena Riedl, Siegfried Waldegger, Alejandra Rosales, Raphaela Trojer, Johannes Hofer
BACKGROUND: Therapeutic plasma exchange (TPE) has evolved to an accepted therapy for selected indications. However, it is technically challenging in children. Moreover, data on safety and efficacy are mainly derived from adult series. The aim of this study was to review the procedure in the context of clinical indications, effectiveness, and safety. STUDY DESIGN AND METHODS: All TPE procedures performed at a tertiary care hospital during a 12-year period (2005-2016) were retrospectively evaluated...
December 2017: Journal of Clinical Apheresis
Autumn Allison, Marissa Delapaz, Claire Meena-Leist, Gina Drobena
No abstract text is available yet for this article.
December 2017: Journal of Clinical Apheresis
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