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Therapeutic apheresis

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https://www.readbyqxmd.com/read/29150875/treatment-of-acquired-thrombotic-thrombocytopenic-purpura-in-the-u-s-remains-heterogeneous-current-and-future-points-of-clinical-equipoise
#1
Marshall A Mazepa, Jay S Raval, Mark E Brecher, Yara A Park
BACKGROUND: The purpose of this survey was to describe current practices in the U.S. for treatment of acquired Thrombotic Thrombocytopenic Purpura (TTP), compare these with prior U.S. and current Canadian practices, and identify areas of clinical equipoise. STUDY DESIGN AND METHODS: A research team member administered the survey by telephone. Questions included an estimate of the annual patient volume treated, apheresis and medical therapy practices for acquired TTP...
November 18, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29139162/epidemiology-of-therapeutic-apheresis-with-a-multidisciplinary-approach-at-a-high-volume-pediatric-center
#2
Rachel M Sirignano, Matthew L Paden, Ross Fasano, Erin K Meyer
INTRODUCTION: Therapeutic apheresis (TA) is used inconsistently in pediatric populations. We seek to define our multidisciplinary institutional practice. METHODS: We conducted a retrospective chart review of patients receiving TA from January 1, 2012 through October 31, 2015. Data collected included demographics, American Society of Apheresis (ASFA) indication, complications, and mortality. RESULTS: Over 46 months, 1198 TA procedures were conducted on 289 patients ranging in age from 5 months to 21 years with weights ranging from 4...
November 15, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29132746/diabetes-mellitus-as-a-poor-mobilizer-condition
#3
REVIEW
Gian Paolo Fadini, John F DiPersio
Hematopoietic stem cell (HSC) transplantation in an effective and curative therapy for numerous hematological malignancies. Mobilization of HSCs from bone marrow (BM) to peripheral blood (PB) followed by apheresis is the gold standard for obtaining HSCs for both autologous and allogeneic stem cell transplantation. After administration of granulocyte-colony stimulating factor (G-CSF), up to 30% of patients fail to mobilize "optimal" numbers of HSCs required for engraftment. This review summarizes the current experimental and clinical evidence that diabetes mellitus is a risk factor for poor mobilization...
November 8, 2017: Blood Reviews
https://www.readbyqxmd.com/read/29106543/survival-in-homozygous-familial-hypercholesterolaemia-is-determined-by-the-on-treatment-level-of-serum-cholesterol
#4
Gilbert R Thompson, Dirk J Blom, A David Marais, Mary Seed, Gillian J Pilcher, Frederick J Raal
Aims: Homozygous familial hypercholesterolaemia (FH) is a rare inherited disorder characterized by extreme hypercholesterolaemia from birth, accelerated atherosclerosis, and premature death. Many forms of lipid-lowering therapies have been used in the past, but definitive evidence of benefit has been lacking. We therefore undertook a retrospective survey of lipid levels and clinical outcomes of FH homozygotes treated with a combination of lipid-lowering measures between 1990 and 2014 in South Africa and the UK...
July 1, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29096860/current-insights-into-the-german-lipoprotein-apheresis-standard-pcsk9-inhibitors-lipoprotein-apheresis-or-both
#5
V J J Schettler, J Ringel, S Jacob, U Julius, R Klingel, F Heigl, E Roeseler, P Grützmacher
According to current European guidelines, lipid lowering therapy for progressive cardiovascular disease including cardiovascular events has to be focused on a target level for LDL-C. In contrast for Lp(a) a threshold has to be defined with respect to the method of measurement. However, due to new lipid lowering drug developments like PCSK9-inhibitors (PCSK-9-I) a therapeutic algorithm for patients with severe hypercholesterolemia or isolated Lipoprotein(a)-hyperlipoproteinemia with progressive cardiovascular disease may be necessary to manage the use of PCSK9-I, lipoprotein apheresis (LA) or both...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096851/how-effectively-will-pcsk9-inhibitors-allow-retrieval-of-freedom-from-apheresis-in-cardiovascular-high-risk-patients-estimates-form-a-large-single-center
#6
Bernd Hohenstein, Sergey Tselmin, Stefan R Bornstein, Ulrich Julius
Lipoprotein apheresis (LA) has been the last-resort therapeutic option in patients suffering from limited pharmaceutical options to lower highly elevated low density lipoprotein cholesterol (LDL-C) levels. Facing the introduction of the proprotein convertase subtilisin/kexine type 9 (PCSK-9) inhibitors, it has been speculated that they might replace LA to a large extend. Given an efficacy of approx. 55-65% to lower LDL-C it is important to analyze whether this might be realistic i) for potential candidates in apheresis sites and ii) for the future structures of the sites themselves...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096844/dysregulation-of-the-cd4-t-cells-lineage-differentiation-in-dyslipidemic-patients-and-impact-of-lipoprotein-apheresis-treatment-a-case-study
#7
J Papin, A Brennand, G Arbore, B Hohenstein, V Kamvissi, C Kemper, S R Bornstein
BACKGROUND AND AIM: Lipoprotein-apheresis (LA) is a therapeutic approach used against severe forms of dyslipidemia in patients who are non-responders or intolerant to pharmacological treatments. However, little is known about the potential pleiotropic effects of LA, particularly regarding the immune system and its regulation. Thus, in an attempt to analyse the potential effects of dyslipidemia and LA on the regulation of CD4(+) T cells activation and lineage differentiation, we compared the CD4(+) T cells cytokines secretion profiles of dyslipidemic patients before and after LA with the profiles observed in healthy donors...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096840/kinetics-of-lipoprotein-a-in-patients-undergoing-weekly-lipoprotein-apheresis-for-lp-a-hyperlipoproteinemia
#8
S Tselmin, G Müller, U Schatz, U Julius, S R Bornstein, B Hohenstein
INTRODUCTION: Lipoprotein apheresis (LA) represents the only effective therapeutic option for patients with elevated Lipoprotein(a) (Lp(a)) levels. We aimed at analyzing the Lp(a) reduction, rebound rates as well as mean interval values between two weekly apheresis sessions, since this might be important for the prediction of the residual cardiovascular risk and development of individualized approaches for this special therapeutic strategy. MATERIALS AND METHODS: 20 patients under weekly and 2 patients under twice weekly apheresis were included...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096839/lipoprotein-apheresis-downregulates-il-1%C3%AE-il-6-and-tnf-%C3%AE-mrna-expression-in-severe-dyslipidaemia
#9
Claudia Stefanutti, Fabio Mazza, Daniela Pasqualetti, Serafina Di Giacomo, Gerald F Watts, Maria Simona Massari, Joel de Neve, Claudia Morozzi, Moritz Fischer
BACKGROUND AND AIMS: Dyslipidaemias are associated with cardiovascular mortality and morbidity, driven by unstable atherosclerotic plaques with inflammatory infiltrates. Levels of messenger RNA (mRNA) for pro-inflammatory cytokines have been positively correlated with atherosclerotic disease progression. Therapeutic lipoprotein apheresis (LA) reduces plasma lipid levels and reduces inflammation. We evaluated the effects of LA on expression of mRNA coding for key pro-inflammatory cytokines in patients with dyslipidaemia, homo-/hetero-zygous familial hypercholesterolaemia (HoFH, HeFH) or hyperlipoprotein(a)aemia [hyperLp(a)] and associated coronary artery disease (CAD)...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096829/ldl-apheresis-improves-coronary-flow-reserve-on-the-left-anterior-descending-artery-in-patients-with-familial-hypercholesterolemia-and-chronic-ischemic-heart-disease
#10
Tiziana Sampietro, Francesco Sbrana, Emilio Maria Pasanisi, Federico Bigazzi, Christina Petersen, Michele Coceani, Beatrice Dal Pino, Andrea Ripoli, Mascia Pianelli, Roberta Luciani
BACKGROUND: LDL apheresis (LA) influences the microcirculation, endothelial function and cardiovascular homeostasis. The aim of our study was to analyze temporal variations of coronary flow reserve (CFR) on the left anterior descending artery, obtained during dipyridamole stress echocardiography (DSE), in patients with severe familial hypercholesterolemia on LA (LA group) or not (not LA group) and ischemic heart disease (IHD). METHODS: The LA group consisted in 10 patients (mean age 65 ± 7 years, male 70%) with Familial Hypercholesterolemia and chronic IHD on maximally tolerated lipid lowering therapy and chronic LA treatment (median 7 years, interquartile range 6-14 years)...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096824/history-of-lipidology-and-lipoprotein-apheresis
#11
Ulrich Julius
This review tells the story of atherosclerosis research in the beginning of the 20th century. It presents the significance of cardiovascular diseases and addresses major questions currently being discussed among lipidologists and the current thinking with respect to low LDL-cholesterol levels and HDL. It provides an overview of the period during which lipid-modifying drugs were introduced and their relevance with respect to cardiovascular outcome data and lists possible reasons why some patients develop new cardiovascular events while being treated with statins...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29071747/the-management-of-anticoagulation-in-patients-undergoing-therapeutic-plasma-exchange-a-concise-review
#12
REVIEW
Sara M Shunkwiler, Huy P Pham, Geoffrey Wool, Tina S Ipe, Deanna C Fang, Elizabeth Biller, Angela Treml, John Weiss, Beverly W Baron, Mary Berg
We surveyed multiple apheresis centers represented by the authors for their clinical approach to the management of anticoagulation issues during therapeutic plasma exchange (TPE). We present the results of their practices and a review of the pertinent literature. As plasma is removed during TPE, replacement with all or partial non-plasma-containing fluids (eg, 5% albumin) may lead to significant changes in hemostasis. These changes are amplified in patients who are receiving anticoagulation. We discuss various anticoagulants as well as the monitoring and adjustment of anticoagulation before, during, and after TPE...
October 26, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29059397/pro-high-dose-of-therapeutic-plasma-exchange-mind-the-gap
#13
Carsten Hafer, Jan T Kielstein
'Mind the gap' is a recorded warning phrase used in the London Tube since 1969. The following article is meant to be a warning of an increasing knowing-doing gap in routine practice of therapeutic plasma exchange (TPE), a treatment method that is used more and more throughout the world. The American Society of Apheresis recommendations, including the most recent ones from 2016, suggest using a TPE volume of 1.0-1.5 times the actual calculated plasma volume of the patient. There are only a few exceptions to that rule, such as the recommnded exchange volume in vasculitis or mushroom poisoning...
September 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29037311/therapeutic-plasma-exchange-in-rheumatic-diseases-a-university-hospital-experience
#14
Juan Pablo Córdoba, Carolina Larrarte, Cristina Estrada, Daniel G Fernández-Ávila
INTRODUCTION: Each day, evidence accumulates related to the use of therapeutic plasma exchange (TPE) in patients with rheumatic diseases. San Ignacio University Hospital has recorded all of the TPE sessions performed by the institution's apheresis group. OBJECTIVE: To describe the TPE experience of patients with rheumatologic diseases in a hospital setting. METHODS: Descriptive, observational, retrospective analysis. This study included analyses of the TPE sessions that were performed in patients with rheumatic diseases from November 2009 to November 2013...
September 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/29027706/regional-citrate-anticoagulation-with-calcium-replacement-in-pediatric-apheresis
#15
Katie Sigler, Ji Lee, Poyyapakkam Srivaths
PURPOSE: The objective of this retrospective analysis was to present our single-center experience with intravenous (IV) calcium replacement and regional citrate anticoagulation in pediatric apheresis therapy with the aim of developing a standard operating procedure to minimize symptomatic hypocalcemia. METHODS: We analyzed apheresis procedures in patients <18 years of age over a 2-year time period (Jan 2012 to Dec 2014). Procedures in tandem with other extracorporeal therapies, including continuous renal replacement therapy, extracorporeal liver support, and extracorporeal membrane oxygenation, were excluded...
October 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29024468/upcoming-meetings-therapeutic-apheresis-and-dialysis-october-2017
#16
(no author information available yet)
No abstract text is available yet for this article.
October 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28970685/therapeutic-leukocyte-reduction-for-acute-and-chronic-myeloid-leukemias-a-4-year-experience-from-an-oncology-center-in-india
#17
Anita A Tendulkar, Puneet A Jain, Abhaykumar Gupta, Nidhi Sharma, Anisha Navkudkar, Vijaya Patle
INTRODUCTION: Hyperleukocytosis (HL) and leukostasis seen in myeloid leukemias are a medical emergency. We present a case series of ten such patients in a 4-year period. Sixteen therapeutic leukocyte reduction (TLR) were done in ten cases along with other supportive measures. The American Society for Apheresis supports the routine implementation of TLR in cases of HL secondary to myeloid leukemias with signs of leukostasis. MATERIALS AND METHODS: The procedures were performed on the intermittent flow cell separator after discussion with the treating physician about patient's condition...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28970002/immunoadsorption-for-collagen-and-rheumatic-diseases
#18
REVIEW
Ken Yamaji
The field of therapeutics has seen remarkable progress in the recent years, which has made mainstream drug treatment possible for collagen and rheumatic diseases. However, treatment of intractable cases where drug effectiveness is poor is a challenge. Furthermore, organ damage, concurrent illnesses or allergic reactions make adequate drug therapy impossible. For such cases, therapeutic apheresis is very significant, and it is important how this should be valued related to drug therapies. Therapeutic apheresis for collagen and rheumatic diseases involves the removal of factors that cause and exacerbate the disease; the aim of immunoadsorption, in particular, is to improve the clinical condition of patients with autoimmune disease by selectively removing pathogenic immune complexes and autoantibodies from their plasma...
August 30, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28969140/therapeutic-plasma-exchange-an-emerging-treatment-modality-in-patients-with-neurologic-and-non-neurologic-diseases
#19
Shreedevi S Bobati, Karkal Ravishankar Naik
INTRODUCTION: Therapeutic Plasma Exchange (TPE) is a procedure in which the patient's blood is passed through an apheresis machine, where the filtered plasma is removed and discarded with reinfusion of red blood cells along with replacement fluid such as plasma or albumin in to the patient. We present our experience with TPE in treatment of various neurologic and non-neurologic diseases. AIM: To evaluate TPE as primary therapy or as a first-line adjunct to other initial therapies as mentioned by American Society for Apheresis (ASFA)...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28964708/ldl-apheresis-in-japan
#20
REVIEW
Hisashi Makino, Tamiko Tamanaha, Mariko Harada-Shiba
LDL apheresis has been developed as the treatment for refractory familial hypercholesterolemia (FH). Currently, plasma exchange, double membrane filtration, and selective LDL adsorption are available in Japan, and selective LDL adsorption is most common method. LDL apheresis can prevent atherosclerosis progression even in homozygous (HoFH). However, in our observational study, HoFH who started LDL apheresis from adulthood had poor prognosis compared with patients who started from childhood. Therefore, as far as possible, HoFH patients need to start LDL apheresis from childhood...
August 31, 2017: Transfusion and Apheresis Science
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