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Journal of Clinical Apheresis

Robert A DeSimone, Sandeep N Wontakal, Alexander K Lyashchenko, Joseph Schwartz
Graft-versus-host disease (GVHD) is a complication of allogeneic hematopoietic stem cell transplantation with high morbidity and mortality. Extracorporeal photopheresis (ECP) is an effective therapy for treating medication-refractory GVHD, however, there is scant evidence of whether ECP can be safely performed in patients weighing less than 15 kg. Here, we report the implementation of a successful protocol to perform ECP in a 21-month-old, 10.6 kg female with medication-refractory GVHD. Our initial ECP treatment resulted in significant hemolysis that was most likely mechanical...
November 28, 2016: Journal of Clinical Apheresis
René Weiss, Michael B Fischer, Viktoria Weber
Lipoprotein apheresis is applied to deplete low density lipoprotein and other apolipoprotein B containing lipoproteins in patients with severe familial hypercholesterolemia, hypertriglyceridemia associated pancreatitis, or lipoprotein (a)-hyperlipoproteinemia. Anticoagulation of the extracorporeal circuit may influence cellular activation, as evidenced by a reduction of inflammatory parameters during regional citrate anticoagulation with acid citrate dextrose A (ACD-A) commonly used in whole blood lipid apheresis...
November 17, 2016: Journal of Clinical Apheresis
José Carlos Jaime-Pérez, Raúl Alberto Jiménez-Castillo, Karina Elizabeth Vázquez-Hernández, Rosario Salazar-Riojas, Nereida Méndez-Ramírez, David Gómez-Almaguer
BACKGROUND: Advances in automated cell separators have improved the efficiency of plateletpheresis and the possibility of obtaining double products (DP). We assessed cell processor accuracy of predicted platelet (PLT) yields with the goal of a better prediction of DP collections. STUDY DESIGN AND METHODS: This retrospective proof-of-concept study included 302 plateletpheresis procedures performed on a Trima Accel v6.0 at the apheresis unit of a hematology department...
November 11, 2016: Journal of Clinical Apheresis
G Jaimovich, M Castro, B Rosales Ostriz, M Fernandez, D Silveyra, R Campestri
No abstract text is available yet for this article.
October 27, 2016: Journal of Clinical Apheresis
Bruce S Sachais
No abstract text is available yet for this article.
October 9, 2016: Journal of Clinical Apheresis
Ravi Sarode, Samir K Ballas, Alicia Garcia, Haewon C Kim, Karen King, Bruce Sachais, Lance A Williams
The American Society for Apheresis (ASFA) conducted a one-day consensus conference on red blood cell exchange (RBCx) in sickle cell disease (SCD) during its annual meeting in San Antonio, TX, on May 5, 2015. The authors of this article, a subcommittee of ASFA's Clinical Applications Committee, developed several questions with regard to pathophysiology of SCD and use of RBCx in the management of various complications. These questions were provided to the seven invited speakers who are the experts in the field of SCD...
October 9, 2016: Journal of Clinical Apheresis
Nathaniel C Warner, Leroy B Vaughan, Richard P Wenzel
HIV complicates the diagnostic and therapeutic approaches to idiopathic thrombotic thrombocytopenic purpura (TTP), prompting debate in the literature regarding the benefit of plasma exchange versus simple plasma infusion. Herein we present a case of HIV-TTP, initially treated conservatively with plasma infusion but because of progressive neurologic decline, required urgent plasma exchange for resolution of hematologic derangements and neurologic sequelae. Based on the available literature, there appears to be a spectrum of HIV-associated TTP disorders...
October 6, 2016: Journal of Clinical Apheresis
Kahori Nasu, Norio Hanafusa, Masaomi Nangaku
Bullous pemphigoid (BP) is an autoimmune blistering skin disorder characterized by circulating serum IgG antibodies against two hemidesmosomal proteins: BP180 and BP230. Fundamentally, immunosuppressive therapies are administered to treat this disease, but plasmapheresis can be added for refractory patients. We experienced the case of a 63-year-old patient with refractory BP for which we administered double filtration plasmapheresis (DFPP). His skin lesions improved along with decreased IgG BP180 antibodies, but factor XIII (FXIII) and fibrinogen were also reduced by DFPP repetition...
October 6, 2016: Journal of Clinical Apheresis
Doris Handschel, Michiel Etienne Janssens, Marion Gericke, Stef De Reys, Helmut Borberg
BACKGROUND: As COBE Spectra has been replaced in many parts of the world, we describe a new protocol for low-density lipoprotein (LDL)-apheresis performed on familial hypercholesterolemia patients for the Spectra Optia platform. METHODS: For all procedures, after administering a bolus of heparin of 2,500 U, 10,000 U of heparin added to a 600 ml ACD-A bag was used as anticoagulant (AC). In a first phase (A), 16 apheresis procedures with COBE Spectra using an inlet:AC ratio of 25:1 were compared to 18 LDL-apheresis treatments with Spectra Optia at split Inlet:AC ratios of 16:1/18:1 or 20:1/25:1...
September 27, 2016: Journal of Clinical Apheresis
Jason Brazelton, Robert A Oster, Brandi McCleskey, Jessica Fuller, Jill Adamski, Marisa B Marques
Thrombotic thrombocytopenic purpura (TTP) has >90% mortality without therapeutic plasma exchange (TPE). Despite TPE, approximately 10% of patients still die, presumably from cardiac ischemia. We sought clinical or laboratory parameters associated with death by reviewing the records of all patients hospitalized with acquired TTP in our institution for 10 years, and collect demographics and results for hemoglobin, platelet count, creatinine, lactate dehydrogenase, transaminases, total bilirubin, creatinine kinase (CK), CK-MB, and troponin I...
September 26, 2016: Journal of Clinical Apheresis
Michael Losos, Scott Scrape, Sarita Joshi, Aaron Shmookler, Jian Chen
Acquired hemophilia A (AHA) is a rare autoimmune disorder that leads to factor VIII (FVIII) deficiency via autoantibody formation. Standard treatment options include FVIII bypassing factors and immunosuppression. However, the role of therapeutic plasma exchange (TPE) is not clear in the treatment of AHA. We present a case of idiopathic AHA in a 66 year old female with severe bleeding and a FVIII inhibitor of 17.6 Bethesda units (BU). She failed to respond to standard treatment including maximum dose of recombinant FVIIa (rFVIIa), rituximab, and other immunosuppressive agents...
September 20, 2016: Journal of Clinical Apheresis
Daniel Putensen, David Leverett, Bhavika Patel, Jasmin Rivera
BACKGROUND: The majority of reports regarding general vascular access choices for apheresis procedures argue that peripheral venous access should be considered first. However, the clinical reality appears to be different. While some procedures mandate central vascular access (e.g., therapeutic apheresis procedures in critically ill patients) and in some cases it is the patient's preference, we propose that the majority of elective procedures can be successfully performed peripherally...
September 15, 2016: Journal of Clinical Apheresis
Yoriko Ishibe, Shigehiro Shibata, Gaku Takahashi, Yasushi Suzuki, Yoshihiro Inoue, Shigeatsu Endo
This study was undertaken to analyze the association of type II secretory phospholipase A2 (sPLA2 -II) and surfactant protein D (SP-D) with the pulmonary oxygenation potential in patients with septic shock during polymyxin-B immobilized fiber-direct hemoperfusion (PMX-DHP). The study was conducted in 25 patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). PMX-DHP lowered the blood endotoxin level in all patients. Following PMX-DHP, there were decreases from day 0 → day 1 → day 2 in both the mean plasma sPLA2 -II level (340 → 260 → 189 ng/mL) and plasma SP-D level (483 → 363 → 252 ng/mL)...
September 13, 2016: Journal of Clinical Apheresis
Gwendolyn van Gorkom, Herve Finel, Sebastian Giebel, David Pohlreich, Avichai Shimoni, Mark Ringhoffer, Gülsan Sucak, Nicolaas Schaap, Peter Dreger, Anna Sureda, Harry C Schouten
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) to rescue hematopoiesis is considered standard care for patients with a relapsed chemosensitive lymphoma, but diagnosis of lymphoma has been a risk factor for poor mobilization in several studies. The aim of this prospective noninterventional clinical audit was to review the mobilization strategies used by EBMT centers in relapsed lymphoma and to evaluate their efficacy. Between 2010 and 2014, 275 patients with relapsed lymphoma from 30 EBMT centers were prospectively registered...
September 10, 2016: Journal of Clinical Apheresis
Chunlan Huang, Jie Liu, Yingying Lu, Junjie Fan, Xingpeng Wang, Jun Liu, Wei Zhang, Yue Zeng
AIM: To analyze the features and treatment of hypertriglyceridemia-induced acute pancreatitis (HTGP) during pregnancy. METHODS: A retrospective study of 21 pregnant women diagnosed with acute pancreatitis (AP) was performed. Patients were divided into acute biliary pancreatitis (ABP), HTGP, and idiopathic groups according to etiology. RESULTS: 95% of the patients were in the third trimester of gestation. The percentage of patients with HTGP was higher than that of ABP (48% vs...
December 2016: Journal of Clinical Apheresis
Sunil Abhyankar, Philip Lubanski, Shaun DeJarnette, Dean Merkel, Jennifer Bunch, Kelly Daniels, Omar Aljitawi, Tara Lin, Sid Ganguly, Joseph McGuirk
Adequate hematopoietic progenitor cell (HPC) collection is critical for patients undergoing autologous HPC transplant (AHPCT). Historically, 15 - 30% of patients failed HPC mobilization with granulocyte-colony stimulating factor (G-CSF) alone. Bortezomib, a proteasome inhibitor, has been shown to down regulate very late antigen-4 (VLA-4), an adhesion molecule expressed on HPCs. In this pilot study, bortezomib was administered on days -11 and -8 at a dose of 1.3 mg/m(2) intravenously (IV) or subcutaneously (SQ), followed by G-CSF 10 mcg/kg SQ, on days -4 to -1 prior to HPC collection (Day 1)...
December 2016: Journal of Clinical Apheresis
Huihui Li, Frances Condon, Debra Kessler, Vijay Nandi, Mark Rebosa, Mark Westerman, Beth H Shaz, Yelena Ginzburg
BACKGROUND: The loss of iron stores and resulting iron deficiency is well documented in whole blood or red blood cell donors. We hypothesized that relative iron deficiency also occurs as a result of more frequent platelet- and plasma-pheresis (apheresis) donation. MATERIALS AND METHODS: To test this hypothesis, we proposed a pilot cross-sectional study to analyze erythropoiesis- and iron-related parameters in white male apheresis donors: (1) relative to controls, (2) in correlation with apheresis donation frequency, and (3) in correlation with pre-donation platelet count...
December 2016: Journal of Clinical Apheresis
Eva Rombout-Sestrienkova, Ger H Koek, Rabin Neslo, Marian van Kraaij, Paul P Menheere, Ad Masclee, Dorine W Swinkels
Current treatment for newly diagnosed patients with hereditary hemochromatosis (HH) and iron overload consist of weekly phlebotomy or less frequent and more personalized erythrocytapheresis. Previous observations during phlebotomy suggest an increase in intestinal iron uptake caused by lowering of hepcidin as a result of intensive bloodletting. It is not known whether such an effect is present or even more pronounced using erythrocytapheresis since a larger amount of iron is extracted per procedure. In this study we aimed to assess the effect of erythrocytapheresis on the course of iron parameters, with special focus on serum hepcidin...
December 2016: Journal of Clinical Apheresis
Dimitris A Tsitsikas, Bala Sirigireddy, Ruben Nzouakou, Alexander Calvey, Joanne Quinn, Janine Collins, Funmilayo Orebayo, Natasha Lewis, Sophie Todd, Roger J Amos
We report here our experience with regular automated red cell exchange transfusion for the management of chronic complications of sickle cell disease in 50 patients in our institution from June 2011 to December 2014. The mean sickle hemoglobin level was 44% and 8.5% pre- and post-transfusion, respectively. Platelets were reduced by a mean 70% during the procedure with a count of less than 50 × 10(9) /l in 6% of cases. The alloimmunization rate was 0.065/100 units of red cells with no hemolytic reactions. Patients with no iron overload at baseline showed no evidence of iron accumulation with a mean liver iron concentration of 1...
December 2016: Journal of Clinical Apheresis
Hisako Saito, Norio Hanafusa, Junko Kishikawa, Eisei Noiri, Eiji Sunami, Soichiro Ishihara, Toshiaki Watanabe, Masaomi Nangaku
Ulcerative colitis (UC) is a major type of idiopathic inflammatory bowel disease (IBD). Immunosuppressive therapies are used to treat IBD patients. Clinicians have strong concerns about using immunosuppressive therapies for IBD patients with hepatitis B virus (HBV) infection because aggressive immunosuppressive therapy can promote reactivation of HBV. For that reason, physicians hesitate to use steroids or other immunosuppressive drugs for IBD patients with HBV infection. Granulocyte monocyte apheresis (GMA) is a safe and effective therapy for UC patients...
December 2016: Journal of Clinical Apheresis
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