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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
Caroline R Alquist, Zbigniew M Szczepiorkowski, Nancy Dunbar
Babesiosis is an increasingly recognized disease which may benefit from therapeutic apheresis (Category II/Grade 2C). Vulnerable populations include the splenectomized, those aged >50, those with malignancies, and the immunocompromised. In the setting of parasite levels > 10%, significant anemia, renal impairment, pulmonary compromise, or hepatic dysfunction, RBC exchange can rapidly reduce parasite burdens and decrease the bioavailability of proinflammatory cytokines. No previous report has shown such a rapid rebound in parasitemia despite adequate organism removal...
September 1, 2016: Journal of Clinical Apheresis
Lynn D Haynes, Jennifer Coonen, Jennifer Post, Kevin Brunner, Debra Bloom, Peiman Hematti, Dixon B Kaufman
BACKGROUND: Nonhuman primates, particularly rhesus macaques, are ideal preclinical large animal models to investigate organ tolerance induction protocols using donor hematopoietic stem cells (HSCs) to induce chimerism. Their relatively small size poses some challenges for the safe and effective collection of peripheral blood HSCs through apheresis procedures. We describe our experiences using the Spectra Optia apheresis unit to successfully obtain HSCs from mobilized peripheral blood of rhesus macaques...
August 31, 2016: Journal of Clinical Apheresis
Nina Worel, Gerhard Fritsch, Hermine Agis, Alexandra Böhm, Georg Engelich, Gerda C Leitner, Klaus Geissler, Karoline Gleixner, Peter Kalhs, Veronika Buxhofer-Ausch, Felix Keil, Gerhard Kopetzky, Viktor Mayr, Werner Rabitsch, Regina Reisner, Konrad Rosskopf, Reinhard Ruckser, Claudia Zoghlami, Niklas Zojer, Hildegard T Greinix
Plerixafor in combination with granulocyte-colony stimulating factor (G-CSF) is approved for autologous stem cell mobilization in poor mobilizing patients with multiple myeloma or malignant lymphoma. The purpose of this study was to evaluate efficacy and safety of plerixafor in an immediate rescue approach, administrated subsequently to G-CSF alone or chemotherapy and G-CSF in patients at risk for mobilization failure. Eighty-five patients mobilized with G-CSF alone or chemotherapy were included. Primary endpoint was the efficacy of the immediate rescue approach of plerixafor to achieve ≥2...
August 31, 2016: Journal of Clinical Apheresis
Aslı Korur, Ilknur Kozanoglu, Nurhilal Buyukkurt, Mahmut Yeral, Fatih Kandemir, Cigdem Gereklioglu, Cagla Sariturk, Suheyl Asma, Soner Solmaz, Can Boga, Hakan Ozdogu
BACKGROUND AND AIM: Today, voluntary donation of peripheral blood stem cells by healthy donors for allogeneic hemopoietic cell transplantation is common worldwide. Such donations are associated with small but measurable risks of morbidity and mortality. Most complications are associated with citrate infusion during cell collection. We studied the effects of citrate infusion on the QTc and other vital parameters during and after peripheral stem cell apheresis in volunteers. METHOD: To ensure that donors were healthy, screening included taking a detailed medical history, physical examination, and laboratory measurements of plasma calcium and magnesium...
August 20, 2016: Journal of Clinical Apheresis
Huy P Pham, Dheeraj Raju, Ning Jiang, Lance A Williams
BACKGROUND: Many practitioners believe in the phenomenon of either being labeled a "black cloud" or "white cloud" while on-call. A "white-cloud" physician is one who usually gets fewer cases. A "black-cloud" is one who often has more cases. It is unclear if the designation is only superstitious or if there is some merit. Our aim is to objectively assess this phenomenon in apheresis medicine at our center. METHODS: A one-year prospective study from 12/2014 to 11/2015 was designed to evaluate the number of times apheresis physicians and nurses were involved with emergent apheresis procedures between the hours from 10 PM and 7 AM...
August 17, 2016: Journal of Clinical Apheresis
Heidi D Lehrke, Jeffrey L Winters
No abstract text is available yet for this article.
August 17, 2016: Journal of Clinical Apheresis
Jeffrey L Winters
No abstract text is available yet for this article.
August 17, 2016: Journal of Clinical Apheresis
Jay S Raval, Marshall A Mazepa, Daniel B Kim-Shapiro, Swati Basu, Raj S Kasthuri, Herbert C Whinna, Yara A Park
No abstract text is available yet for this article.
August 17, 2016: Journal of Clinical Apheresis
Peter A Millward, Alice Ma, Shauna N Hay, Mark E Brecher, Nicholas Bandarenko
No abstract text is available yet for this article.
August 17, 2016: Journal of Clinical Apheresis
Eric Salazar, Salvador Garcia, Robin Miguel, Francisco J Segura, Tina S Ipe, Christopher Leveque
Therapeutic and donor apheresis requires adequate vascular access to achieve inlet flow rates of ∼50-100 mL/min. While central dialysis-type venous catheters can usually provide such access, their use includes several associated risks. Some of these risks can be avoided or diminished if adequate peripheral venous access can be established. Some patients have adequate peripheral veins for apheresis that cannot be readily identified visually or by palpation. We hypothesized that ultrasound-guided peripheral venous access would benefit such patients and would lead to placement of fewer central venous catheters...
August 10, 2016: Journal of Clinical Apheresis
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