Role of therapeutic apheresis in pediatric disorders

Hans, Rekha; Prakash, Satya; Sharma, Ratti Ram; Marwaha, Neelam

doi:10.1016/j.phoj.2016.11.002

Cited by 3 publications

(2 citation statements)

References 39 publications

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“…The unique challenges to ensuring safe and efficacious use of apheresis with pediatric patients lead to underutilization 7 . Apheresis equipment is designed for adult patients; thus, consideration must be given to extracorporeal blood volumes, vascular access, anticoagulation, and psychological aspects 8 . Frequency of patient‐related adverse events in children varies widely, from 4% to 55% of procedures.…”

Section: Discussionmentioning

confidence: 99%

“…7 Apheresis equipment is designed for adult patients; thus, consideration must be given to extracorporeal blood volumes, vascular access, anticoagulation, and psychological aspects. 8 Frequency of patient-related adverse events in children varies widely, from 4% to 55% of procedures. Particularly, hypovolemia and hypocalcemia appear to be more common and more serious in pediatric patients and are more difficult to recognize early.…”

Section: Discussionmentioning

confidence: 99%

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Therapeutic plasma exchange for multiorgan dysfunction among critically ill pediatric patients with leukemia: A single‐institutional experience

Dermott

Dargan

Dominguez

et al. 2022

J of Clinical Apheresis

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Introduction: Therapeutic plasma exchange (TPE) has well-documented applications in the adult population, outlined by the American Society for Apheresis (ASFA) 2019 guidelines. Limited data exist regarding the use of TPE in critically ill pediatric patients; however, these reports rarely include patients with oncological diseases. Methods: We highlight the use of TPE in the acute management of seven pediatric patients with leukemia treated at Children's Mercy Hospital ICU from 2015 to 2020, including TPE specifications, baseline and interval laboratory evaluation, and outcome measures. Analysis compared those who did (n = 4) and did not (n = 3) survive 30 days post-TPE. Results: Multiorgan failure (MOF) prompted the initiation of TPE in 85.7% of patients, 57.1% of whom were also diagnosed with hemophagocytic lymphohistiocytosis (HLH). Baseline laboratory evaluations prior to initiation of TPE were similar between the two groups. With subsequent TPE treatments, C-reactive protein (CRP) and lactic acid decreased. CRP and lactic acid following the last TPE treatment were significantly higher for those deceased 30 days post-TPE (P = .023 and .031, respectively). No TPE-associated adverse events necessitated discontinuation of TPE treatment. Several surviving patients required chemotherapy dose reductions or alterations. Conclusion: Our cohort demonstrated MOF and HLH consistently as indications for TPE, currently ASFA category III indications (optimal role of apheresis is not yet established). Recognition of this treatment modality earlier in the clinical course for critically ill oncological patients may lead to the development of formal protocols that may result in earlier initiation of TPE and improved outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Therapeutic plasma exchange for multiorgan dysfunction among critically ill pediatric patients with leukemia: A single‐institutional experience

Dermott

Dargan

Dominguez

et al. 2022

J of Clinical Apheresis

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Centrifugal Therapeutic Plasma Exchange in Pediatric Patients

et al. 2021

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Thrombocytapheresis: An important therapeutic tool in the management of thrombocytosis in cerebral venous thrombosis

Sadhana¹

2020

Int J Blood Transfus Immunohematol

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Introduction: Therapeutic thrombocytapheresis is an effective and useful measure of platelet reduction in patients with severe thrombocytosis from various primary or secondary causes of thrombocytosis to relieve patient of debilitating complications. American Society of Apheresis (ASFA) has recommended platelet reduction by thrombocytapheresis procedures for symptomatic relief in essential thrombocythemia and polycythemia vera indications under category 2C, but other causes are not included in this category by ASFA. Case Report: Here, a case of cerebral venous thrombosis is presented which developed severe thrombocytosis in the post-operative period as secondary (reactive) cause to acute hemorrhage and benefitted after successful therapeutic thrombocytapheresis procedures without any debilitating or residual complications of neurosurgery. Conclusion: This case highlights the importance of therapeutic platelet reduction by a very simple and easy plateletapheresis procedure which is routinely done in many blood establishments globally for other indications.

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Role of therapeutic apheresis in pediatric disorders

Cited by 3 publications

References 39 publications

Therapeutic plasma exchange for multiorgan dysfunction among critically ill pediatric patients with leukemia: A single‐institutional experience

Therapeutic plasma exchange for multiorgan dysfunction among critically ill pediatric patients with leukemia: A single‐institutional experience

Centrifugal Therapeutic Plasma Exchange in Pediatric Patients

Thrombocytapheresis: An important therapeutic tool in the management of thrombocytosis in cerebral venous thrombosis

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