Clinical Application of Apheresis in Very Small Dogs Weighing &lt;8 kg to Pediatric Patients

Sekiguchi, Tomoko; Vigani, Alessio; Ripoll, Alexandra Z; Taylor, Scott; Culler, Christine A.; Suter, Steven E.

doi:10.1111/1744-9987.13432

Cited by 7 publications

(13 citation statements)

References 22 publications

(45 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The development of hypocalcemia during cTPE is exacerbated by the fact that a large amount of patient plasma (containing infused calcium gluconate) is removed during the procedure. As such, dogs undergoing cTPE tend to have a much higher requirement for infused calcium gluconate than dogs undergoing large‐volume leukapheresis where the mononuclear cell apheresis product is only ∼150–200 ml 14,15,18 . This point is emphasized by the one dog in this report that developed severe hypocalcemia and subsequent cardiac arrest upon rinseback after the first procedure, necessitating a 600‐mg calcium gluconate bolus and cardiac compression.…”

Section: Discussionmentioning

confidence: 83%

Centrifugal therapeutic plasma exchange in dogs with immune‐mediated hemolytic anemia (2016–2018): 7 cases

Culler

Vigani

Ripoll

et al. 2022

J Vet Emergen Crit Care

Self Cite

View full text Add to dashboard Cite

Objective: To describe the technique of centrifugal therapeutic plasma exchange (cTPE) in dogs diagnosed with immune-mediated hemolytic anemia (IMHA) and summarize the outcome of the procedure.Design: Retrospective review of cTPE performed at North Carolina State University from 2016 to 2018, through a search of the institutional database for cTPE and IMHA.Setting: University teaching hospital.Animals: Seven dogs with confirmed IMHA were presented to a university teaching hospital ICU for cTPE. Six dogs were not responsive to standard medical management with immunosuppressive agents, while 1 dog presented before immunosuppressive agents were begun. Interventions:All dogs underwent multiple cTPE procedures using 1 of 2 commercially available apheresis systems. Measurements and Main Results:At presentation, the median HCT was 0.15 L/L (15.7%) (range, 0.10-0.19 L/L [10.3%-19%]) and the median total serum bilirubin was 32.5 mmol/L (1.9 mg/dl) (range, 15.4-597 mmol/L [0.9-34.9 mg/dl]). The median number of transfusions before cTPE was 1 (range, 1-4), with a median total of infused RBCs of 12.9 ml/kg (range, 8.8-37 ml/kg). cTPE with an exchange of ≥4 times total plasma volumes was used to decrease the level of circulating autoreactive antibodies.The median total plasma volumes exchanged was 4.5 times (range, 2.5-6.5 times) over 2-4 procedures. Anticoagulation was performed using a combination of systemic heparinization and regional citrate in all dogs. Six of 7 dogs (85.7%) were discharged from the hospital and were alive 90 days after discharge. One dog (14%) did not respond to cTPE (∼6.5 times total plasma volume exchanged) and was euthanized.Conclusions: cTPE is a feasible and relatively safe bridging treatment option for the management of canine IMHA.

show abstract

Section: Discussionmentioning

confidence: 83%

Centrifugal therapeutic plasma exchange in dogs with immune‐mediated hemolytic anemia (2016–2018): 7 cases

Culler

Vigani

Ripoll

et al. 2022

J Vet Emergen Crit Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…After complete staging, mobilization was performed for 5 days using Neupogen (rhG-CSF, 5 ug/kg SC BID). After a double dose of Neupogen on the morning of d5, peripheral blood mononuclear cells were collected with either a COBESpectra ® or Terumo Optia ® apheresis system using a continuous mononuclear cell collection protocol, as previously described ( 17 , 18 ).…”

Section: Methodsmentioning

confidence: 99%

A Retrospective Analysis: Autologous Peripheral Blood Hematopoietic Stem Cell Transplant Combined With Adoptive T-Cell Therapy for the Treatment of High-Grade B-Cell Lymphoma in Ten Dogs

2021

View full text Add to dashboard Cite

In humans, a type of cellular immunotherapy, called adoptive T cell transfer (ACT), can elicit curative responses against hematological malignancies and melanoma. ACT using ex vivo expanded peripheral blood T-cells after multiagent chemotherapy enhances tumor-free survival of dogs with B-cell lymphoma (LSA). Since 2008, our group has been performing autologous peripheral blood hematopoietic stem cell transplants (autoPBHSCT) for the treatment of canine high-grade B-cell LSA, although relapse of residual disease is a common cause of reduced survival in ~70% of treated dogs. We reasoned that a more aggressive treatment protocol combining CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy, autoPBHSCT, and ACT to treat 10 dogs with B-cell LSA could lead to better outcomes when compared to dogs treated with CHOP chemotherapy and autoPBHSCT alone. Using this protocol, once dogs achieved complete hematologic reconstitution post-autoPBHSCT, CD3+ CD8+ and CD3+CD4+ T-cells were expanded from the peripheral blood at a commercial laboratory. Two to four ACT infusions were given to each dog, with a total of 23 infusions given. Infusions were administered with no complications or adverse events. The median cell dose for all infusions was 5.62 x 106 cells/kg (range: 2.59 x 106-8.55 x 106 cells/kg). 4/10 (40%) of dogs were cured of their disease (defined as disease-free for ≥2 years post-autoPBHSCT). Our results confirm that the autoPBHSCT protocol did not hinder the in vitro expansion of autologous peripheral blood T-cells and that the final product could be administered safely, with no adverse events recorded. Finally, since only ten dogs were treated, our results can only suggest that the administration of ACT to dogs after multiagent chemotherapy and autoPHSCT did not lead to a statistically significant increase in median disease-free interval and overall survival when compared to dogs who received CHOP chemotherapy and autoPHSCT alone.

show abstract

“…Veterinary studies describing extracorporeal techniques consistently describe thrombotic complications related to the filter or the central venous catheter. However, across all studies reviewed, no systemic thrombotic complications were noted in dogs undergoing membrane therapeutic plasma exchange (n = 51), 324–326 intermittent hemodialysis (n = 183), 327,328 or centrifugal apheresis (n = 4) 329 . Anticoagulation strategies, when used, were limited to the duration of the session and varied among the studies reviewed.…”

Section: Peco Question: Extracorporeal Circuits (Dogs)mentioning

confidence: 99%

“…However, across all studies reviewed, no systemic thrombotic complications were noted in dogs undergoing membrane therapeutic plasma exchange (n = 51), [324][325][326] intermittent hemodialysis (n = 183), 327,328 or centrifugal apheresis (n = 4). 329 Anticoagulation strategies, when used, were limited to the duration of the session and varied among the studies reviewed. The overall quality of evidence was judged to be low because of the retrospective nature of the studies and the lack of monitoring for systemic thrombosis.…”

Section: Evidence Summarymentioning

confidence: 99%

2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1‐ Defining populations at risk

deLaforcade

Bacek

Blais

et al. 2022

J Vet Emergen Crit Care

View full text Add to dashboard Cite

Objectives: To expand the number of conditions and interventions explored for their associations with thrombosis in the veterinary literature and to provide the basis for prescribing recommendations. Design: A population exposure comparison outcome format was used to represent patient, exposure, comparison, and outcome. Population Exposure Comparison Outcome questions were distributed to worksheet authors who performed comprehensive searches, summarized the evidence, and created guideline recommendations that were reviewed by domain chairs. The revised guidelines then underwent the Delphi survey process to reach consensus on the final guidelines. Diseases evaluated in this iteration included heartworm disease (dogs and cats), immune-mediated hemolytic anemia (cats), protein-losing nephropathy (cats), protein-losing enteropathy (dogs and cats), sepsis (cats), hyperadrenocorticism (cats), liver disease (dogs), congenital portosystemic shunts (dogs and cats) and the following interventions: IV catheters (dogs and cats), arterial catheters (dogs and cats), vascular access ports (dogs and cats), extracorporeal circuits (dogs and cats) and transvenous pacemakers (dogs and cats).Results: Of the diseases evaluated in this iteration, a high risk for thrombosis was defined as heartworm disease or protein-losing enteropathy. Low risk for thrombosis was defined as dogs with liver disease, cats with immune-mediated hemolytic anemia, protein-losing nephropathy, sepsis, or hyperadrenocorticism. Conclusions:Associations with thrombosis are outlined for various conditions and interventions and provide the basis for management recommendations. Numerous knowledge gaps were identified that represent opportunities for future studies.

show abstract

Clinical Application of Apheresis in Very Small Dogs Weighing <8 kg to Pediatric Patients

Abstract: Apheresis in low body weight children and adoles-

Cited by 7 publications

References 22 publications

Centrifugal therapeutic plasma exchange in dogs with immune‐mediated hemolytic anemia (2016–2018): 7 cases

Centrifugal therapeutic plasma exchange in dogs with immune‐mediated hemolytic anemia (2016–2018): 7 cases

A Retrospective Analysis: Autologous Peripheral Blood Hematopoietic Stem Cell Transplant Combined With Adoptive T-Cell Therapy for the Treatment of High-Grade B-Cell Lymphoma in Ten Dogs

2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1‐ Defining populations at risk

Contact Info

Product

Resources

About