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Journal of Clinical Apheresis

Amena Usmani, Laura Kwan, Dina Wahib-Khalil, Jaya Trivedi, Sharon Nations, Ravi Sarode
INTRODUCTION: The primary objective of this study was to assess response to plasma exchange (PLEX) in myasthenia gravis (MG) patients with and without autoantibodies (Ab) to acetylcholine receptor (AChR) or muscle-specific kinase (MuSK). Analysis was also done to determine if correlation existed between sex, early or late onset MG, thymoma, or thymectomy and response to PLEX. MATERIALS AND METHODS: Data was analyzed on 58 consecutive MG patients treated with PLEX...
February 19, 2019: Journal of Clinical Apheresis
Ganesh Mohan, Pruthvi Raj Guduri, Shamee Shastry
Post snake bite renal failure due to thrombotic microangiopathy (TMA) is often overlooked and not considered as a separate entity while managing the patient. This case report highlights the efficacy of Therapeutic Plasma Exchange in managing the post envenomation TMA. Anti-snake venom was administered following severe hematotoxic envenomation, but later on developed acute kidney injury and hence hemodialysis was done for 2 days without much improvement. On third day of bite, diagnosis of TMA was made from microangiopathic hemolytic picture in peripheral blood smear, thrombocytopenia and renal failure...
February 19, 2019: Journal of Clinical Apheresis
Pervin Topcuoglu, Muhit Ozcan
No abstract text is available yet for this article.
February 19, 2019: Journal of Clinical Apheresis
Sean R Regner, Nathan Lerfald
Thrombotic microangiopathies are rare diseases associated with significant morbidity and mortality. The treatment of thrombotic thrombocytopenic purpura (TTP) and drug-induced thrombotic microangiopathy (DITMA) remains a diagnostic dilemma as they present similarly but respond differently to standard treatment with plasma exchange. TTP is a deficiency of a disintegrin and metalloprotease with thrombospondin type 1 motif 13 resulting in von Willebrand factor aggregates. DITMA is due to vascular and platelet toxicity...
February 18, 2019: Journal of Clinical Apheresis
Luca Pierelli, Vincenzo Iaconianni, Michele Vacca
Therapeutic apheresis (TA) includes a wide range of therapeutic procedures based on the separation of blood components and the collection of cells with therapeutic activity or the removal of unwanted plasma or cellular components involved in the etiology of various hematologic, renal, neurological, and medical diseases. The complexity of these interventions requires an organizing model to assure a proper clinical environment, technology, quality requirements, and personnel as well as an active system for outcome monitoring for safety and efficacy...
February 18, 2019: Journal of Clinical Apheresis
Jia Yao, Shuang Li, Li Zhou, Lei Luo, Lili Yuan, Zhongping Duan, Jun Xu, Yu Chen
OBJECTIVE: The artificial liver support system (ALSS) is used frequently as a first-line treatment for hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF). This study aims to compare the therapeutic efficacy of double plasma molecular adsorption system (DPMAS) with sequential half-dose plasma exchange (PE) (DPMAS+PE) and full-dose PE in patients with HBV-ACLF. METHODS: A total of 131 hospitalized patients who were diagnosed with HBV-ACLF and underwent DPMAS+PE or PE were retrospectively analyzed...
February 13, 2019: Journal of Clinical Apheresis
Azizah Masoet, Fatima Bassa, Mogamat-Yazied Chothia
BACKGROUND: HIV-associated thrombotic thrombocytopaenic purpura (TTP) is thought to represent the majority of current TTP diagnoses in South Africa (SA). AIM: The primary aim was to describe the clinical features and compare the time to remission of TTP in those patients with and without HIV. DESIGN: A retrospective cohort study conducted at Tygerberg Hospital in Cape Town, SA for the period January 1, 2010 to January 31, 2015. METHODS: All adult patients requiring ≥5 units of plasma products for ≥1 day during hospitalization were screened for a diagnosis of TTP...
February 13, 2019: Journal of Clinical Apheresis
Mark Lipphardt, Johannes Mühlhausen, Bernd Kitze, Franz Heigl, Erich Mauch, Hans-Joachim Helms, Gerhard A Müller, Michael J Koziolek
BACKGROUND: Plasma exchange (PE) and immunoadsorption (IA) are alternative treatments of steroid-refractory relapses of multiple sclerosis (MS) or neuromyelitis optica (NMO). METHODS: Adverse events and neurological follow-ups in 127 MS- (62 PE, 65 IA) and 13 NMO- (11 PE, 2 IA) patients were retrospectively analyzed. Response was defined by improvements in either expanded disability status scale (EDSS) by at least 1.0 or visual acuity (VA) to 0.5, confirmed after 3 and/or 6 months...
January 30, 2019: Journal of Clinical Apheresis
Rebeca Bailén, Ana María Pérez-Corral, Cristina Pascual, Mi Kwon, David Serrano, Jorge Gayoso, Pascual Balsalobre, Cristina Muñoz, José Luis Díez-Martín, Javier Anguita
BACKGROUND: Poor mobilization results are unexpected after G-CSF-induced peripheral blood stem cell collection in healthy donors. However, 2%-5% of the donors are poor mobilizers. Factors predicting CD34+-cell yield after mobilization in related alternative donors are still poorly known. PATIENTS AND METHODS: Baseline characteristics and efficacy results of G-CSF induced mobilization of 159 adult healthy donors in our institution from 2008 to 2016 were retrospectively analyzed...
January 29, 2019: Journal of Clinical Apheresis
Lance A Williams, James Sikora, Carole Richardson, Mohammed Rigi, Nick Boshell, Lakeyra Palmer, Sondra Dunn, Terry Slover, Daniel Peavey, Bryan Guillory, Marisa B Marques
PURPOSE: During a national shortage of calcium gluconate, we switched to calcium chloride for routine supplementation for peripheral blood stem cell (PBSC) collections. Subsequently, we analyzed the postprocedure ionized calcium level, as we aimed for an equivalent result compared to before the shortage. METHODS: Pharmacy representatives helped us to find an "equivalent" substitute for calcium gluconate at 46.5 mEq in 500 mL normal saline, infused at 100 mL/hour...
January 23, 2019: Journal of Clinical Apheresis
Raquel Almeida-Dias, Marta Garrote, Joan Cid, Maria-Jesús Mustieles, Cristina Alba, Miquel Lozano
Essential thrombocytosis (ET) is a chronic myeloproliferative neoplasm characterized by the presence of thrombocytosis and it can be complicated by thrombotic and/or hemorrhagic events. Treatment options include low-dose aspirin and cytoreductive agents such as hydroxyurea. In cases of extreme thrombocytosis, therapeutic thrombocytapheresis can be a useful procedure. We present a case of a 61-year-old-man previously diagnosed with CALR-mutated ET, who develop acute myeloid leukemia. When recovering after induction chemotherapy, he developed an extreme thrombocytosis up to 2337 × 109 /L regardless hydroxyurea was started...
January 9, 2019: Journal of Clinical Apheresis
Xiaofeng Zhao, Edward J Yoon, Massa Zantah, Mohamed Alsammak
No abstract text is available yet for this article.
December 30, 2018: Journal of Clinical Apheresis
Fatima Aldarweesh, Karen Schaser, John Weiss, Joseph Connor
We report the impact of measuring the hematocrit (HCT) of blood prime units (BPUs) on postprocedure patient HCT values in a small child with transverse myelitis undergoing therapeutic plasma exchange (TPE). Initially, the BPU HCT values were not measured, according to our apheresis policy of using our blood center's estimated HCT value. This approach resulted in unexpected increasing elevations of our patient's post-TPE HCT after the first two TPE procedures. Subsequent measurement of the BPU HCT prior to use stabilized the patient's post-TPE HCT...
December 28, 2018: Journal of Clinical Apheresis
Seung Jun Choi, Hoon Seok Kim, Yonggoo Kim, Jong Wook Lee, Jihyang Lim
INTRODUCTION: We retrospectively analyzed data of recipients who underwent three consecutive therapeutic plasma exchanges (TPEs) before major ABO-incompatible (ABOi) hematopoietic stem cell transplantation (HSCT) in our hospital from 2012 to 2017 and evaluated the efficacy of TPE for successful ABOi HSCT. MATERIALS AND METHODS: We investigated the efficacy of TPE in 29 recipients with major ABOi HSCT based on the following: (1) requirement of red blood cell (RBC) transfusion during 100 days, (2) erythrocyte engraftment by reticulocyte count at 3 months, and (3) erythropoiesis recovery by bone marrow examination at 1 month and 3 months after ABOi HSCT...
December 20, 2018: Journal of Clinical Apheresis
Cristina Pascual, Elena González-Arias, Ana María Pérez-Corral, Rebeca Bailén, Jorge Gayoso, Nelly Besson, David Serrano, Mi Kwon, Javier Anguita, José Luis Díez-Martín
BACKGROUND: Extracorporeal photopheresis (ECP) is an efficient and established therapy to treat acute and chronic graft vs host disease (GVHD). Using an "off-line" method, the first step (mononuclear cell [MNC] collection) is decisive, as long as a high MNC yield and purity in the collected product is desirable. Two "off-line" devices were compared: the COBE Spectra and the Spectra Optia (Terumo BCT), using both continuous and intermittent protocols. PATIENTS AND METHODS: Twelve patients with GvHD (7 acute/5 chronic) were enrolled between June 2014 and May 2015 and were alternatively assigned for each procedure to either the COBE Spectra or the Spectra Optia cell separator...
December 14, 2018: Journal of Clinical Apheresis
Lance A Williams, Christine Arnesen, Christina Gunn, Michael N Boshell, Huy P Pham, Bryan Guillory, Jill Adamski, Marisa B Marques
Many vascular access options, such as subcutaneous ports, are currently on the market for use in both medication infusion and for procedures, such as therapeutic plasma exchange and extracorporeal photopheresis. We compared the cost and time necessary to complete apheresis procedures using either Angiodynamic's Vortex or Bard's PowerFlow subcutaneous ports by reviewing our experience on two patients undergoing long-term apheresis treatments with at least 10 procedures with each type of port. We analyzed the cost of needles and thrombolytic therapy, staff time, overall procedure length, and the total time the patient was in the apheresis unit...
December 12, 2018: Journal of Clinical Apheresis
James M Szymanski, Meryl Waldman, Cathy Conry-Cantilena, Kamille Aisha West
Idiopathic membranous nephropathy is the most common cause of nephrotic syndrome in nondiabetic adults. The antibody most often implicated is the M-type phospholipase A2 receptor (PLA2R) antibody, found in >70% of primary membranous nephropathy cases. First-line therapy is immunosuppressive in nature, but for patients who are treatment-resistant there is a significant risk of end-stage renal disease and mortality. Hypercholesterolemia is not only a side effect of nephrotic syndrome, but also its presence may worsen renal function...
December 10, 2018: Journal of Clinical Apheresis
Theoni Kanellopoulou, Theodora Kostelidou
BACKGROUND: Perioperative therapeutic plasma exchange in patients with cardiovascular diseases poses several challenges, including alterations in intravascular volume, serum electrolytes, the coagulation cascade, and drug pharmacokinetics. METHODS: This review article summarizes different indications of plasma exchange for patients requiring cardiac surgery based on reported case reports and case series. RESULTS: The most common reported indication is plasma exchange for the management of allosensitized cardiac transplant candidate patients in combination with immunosuppressive regimens, which increases the likelihood of obtaining a cross-match-negative allograft, improving post-transplant clinical outcome...
December 8, 2018: Journal of Clinical Apheresis
Léanne Swart, Elise Schapkaitz, Johnny N Mahlangu
INTRODUCTION: Thrombotic thrombocytopenic purpura (TTP) is associated with high mortality if not managed timeously with therapeutic plasma exchange (TPE). TTP secondary to human immunodeficiency virus (HIV) infection is unique to sub-Saharan Africa. The management and outcome of TTP in the era of improved access to therapy has not been described. METHODS: The present study describes the clinical presentation, treatment, therapeutic endpoints, and outcome of TTP patients at the Charlotte Maxeke Johannesburg Academic Hospital, South Africa...
December 8, 2018: Journal of Clinical Apheresis
Robert A DeSimone, Gary D Myers, Erin M Guest, Patricia A Shi
Collecting a sufficient number of T-cells is a critical first step in the production of chimeric antigen receptor (CAR)-T cells. Herein, we report a successful implementation of anticoagulation with combined heparin and acid citrate dextrose solution A (ACD-A) for the continuous mononuclear cell (CMNC) protocol on the Spectra Optia in a 20-month-old, 7.5 kg patient with refractory acute lymphoblastic leukemia for manufacture of tisagenlecleucel, a CAR-T cell therapy. Combined heparin/ACD-A was used following clotting issues when ACD-A was used alone during initial CMNC collections...
November 29, 2018: Journal of Clinical Apheresis
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