Journal of Clinical Apheresis最新文献

{"title":"An Annual Review of Important Apheresis Articles From the American Society for Apheresis Attending Physician Subcommittee","authors":"Yvette C. Tanhehco,&nbsp;Mohamed Alsammak,&nbsp;Ding Wen Wu,&nbsp;Victoria Costa,&nbsp;Vishesh Chhibber,&nbsp;Yosef Levenbrown,&nbsp;Yanhua Li,&nbsp;Wen Lu,&nbsp;Adela D. Mattiazzi,&nbsp;Laura D. Stephens,&nbsp;Daniel K. Noland,&nbsp;Marisa C. Saint Martin,&nbsp;Nirupama Singh,&nbsp;Nicole D. Zantek,&nbsp;Joanne Becker,&nbsp;Gay Wehrli","doi":"10.1002/jca.22152","DOIUrl":"10.1002/jca.22152","url":null,"abstract":"<div>\u0000 \u0000 <p>In this first annual review article, the American Society for Apheresis (ASFA) Attending Physician Subcommittee (APSc) of the Physicians' Committee (PC) curated key apheresis literature in 2023 and presented their choices for the 10 most seminal apheresis articles. PubMed and OVID search engines were used to identify manuscripts from four topic areas: donor apheresis, therapeutic apheresis, education, and cellular therapy. To further identify seminal criteria, they had to present at least one of the following: novel findings, practice-altering outcomes, international scope, randomized controlled trial, relevant to current clinical practice, and/or provide evidence for category III or IV indications based on the ASFA ninth special issue of the Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach. Inclusion criteria included: full-length, peer-reviewed, English language, and human subjects. Case reports, review articles, and meta-analyses were excluded.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"39 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mystery Solved: Acquired Hemoglobin After Red Cell Exchange on Sickle Cell Patient","authors":"Nada Naiyer,&nbsp;David Keren,&nbsp;Chisa Yamada","doi":"10.1002/jca.22148","DOIUrl":"10.1002/jca.22148","url":null,"abstract":"<div>\u0000 \u0000 <p>We report a case of an acquired Hb after an RBCEx.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"39 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Plasma Exchange for the Symptomatic Treatment of Scleromyxedema: A Case Report and Literature Review","authors":"Matthew H. Lanehart,&nbsp;Erika S. Johnson,&nbsp;Nicole A. Aqui","doi":"10.1002/jca.22153","DOIUrl":"10.1002/jca.22153","url":null,"abstract":"<p>Scleromyxedema is a rare skin mucinosis often associated with systemic involvement and monoclonal gammopathy (MG). No formal recommendation for management with therapeutic plasma exchange (TPE) has been published due to rarity. This paper reports a 42-year-old male with progressive scleromyxedema. The patient was treated with glucocorticoids, immunosuppressants, and intravenous immunoglobulin (IVIG) therapy, but the disease progressed. Ultimately, the patient was referred for TPE, which resulted in decreased skin stiffness, improved extremity range of motion, and decreased visibility of papules on the hands. The patient's debilitating dysphagia gradually improved. A review of the literature focusing on clinical response identified five cases of scleromyxedema patients treated with TPE. Three of the five cases reported significant improvement in cutaneous symptoms and range of motion for at least 12 months. Overall, we propose that TPE should be considered an effective supportive treatment for symptomatic relief in severe or refractory scleromyxedema.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"39 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.22153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Plasma Exchange Management for a Pediatric Patient Presenting With Immune Thrombotic Thrombocytopenic Purpura in a Setting of Common Variable Immunodeficiency","authors":"Albert Budhipramono,&nbsp;Ruchika Sharma,&nbsp;Christian Allen Wysocki,&nbsp;Ayesha N. Zia,&nbsp;Brian D. Adkins","doi":"10.1002/jca.22154","DOIUrl":"10.1002/jca.22154","url":null,"abstract":"<p>Common variable immunodeficiency (CVID) is a disorder characterized by hypogammaglobulinemia resulting in recurrent infections. While autoimmune disorders are common in patients with CVID, no association has been reported between CVID and immune thrombotic thrombocytopenic purpura (iTTP), a disorder most often caused by autoantibodies that compromise the activity of the enzyme ADAMTS13. Reduced ADAMTS13 activity results in the accumulation of large von Willebrand factor multimers that can consume platelets and cause microvascular thrombosis and organ injury, ultimately resulting in mortality in most cases of untreated iTTP. Here, we report a 12-year-old male with CVID who developed iTTP, underwent therapeutic plasma exchange (TPE), and subsequently recovered. We conducted a systematic review for other cases of CVID co-occurring with iTTP and present additional cases of this rare presentation. We highlight the importance of prompt recognition of iTTP in a patient with CVID and timely initiation of TPE.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"39 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.22154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobilization and Apheresis Collection Strategies to Reduce Platelet Loss in G-CSF Mobilized Healthy Adult Donors","authors":"Brittany Castro,&nbsp;Jane Huang,&nbsp;Julie Le,&nbsp;Diana Pascua,&nbsp;Hirona Goto,&nbsp;Denise Kirby,&nbsp;David Lin","doi":"10.1002/jca.22150","DOIUrl":"10.1002/jca.22150","url":null,"abstract":"<div>\u0000 \u0000 <p>Granulocyte-colony stimulating factor (G-CSF) mobilizes hematopoietic progenitor cells (HPC) into the peripheral blood. Donor peripheral blood platelet loss has been observed during both G-CSF mobilization and apheresis collection. This study evaluates two strategies to reduce donor platelet loss, preserve product CD34+ cell yield and collection efficiency and increase volume of whole blood (WB) processed. One hundred and two adults healthy donors were mobilized with either standard dose G-CSF (9.5–12 mcg/kg/day × 4 days) or lower dose G-CSF (7.5–10 mcg/kg/day × 4 days) according to their pre-mobilization platelet count. Apheresis centrifugal force was adjusted by lowering the packing factor (PF) setting on the apheresis instrument. Between-group differences were observed in absolute donor platelet loss (<i>p</i> = 0.04) favoring lower G-CSF dosing, while percent donor platelet loss trended towards significance (<i>p</i> = 0.10). Lowering PF from the manufacturer's default of 4.5 to 4.0 demonstrated between-group differences in absolute donor platelet loss (<i>p</i> &lt; 0.05), percent donor platelet loss (<i>p</i> &lt; 0.001), and apheresis product platelet content (<i>p</i> &lt; 0.001). No differences were observed in the product CD34+ cell content and CD34+ cell collection efficiency when PF was reduced to 4.0. Additionally, a higher volume of WB could be processed due to reduced donor platelet loss. Together, these two strategies may mitigate the risk of cumulative platelet loss in G-CSF mobilized healthy donors undergoing apheresis collection, thereby increasing the likelihood of completing the target total blood volume to be processed while maintaining donor safety.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"39 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a Standardized Regimen of Therapeutic Plasma Exchange and IVIG for Treatment of Antibody-Mediated Rejection in Lung Transplant Recipients","authors":"Amelework Wodajo,&nbsp;Ravi Sarode,&nbsp;Nicole De Simone,&nbsp;Vaidehi Kaza,&nbsp;Amena Usmani","doi":"10.1002/jca.22151","DOIUrl":"10.1002/jca.22151","url":null,"abstract":"<p>Antibody-mediated rejection (AMR) in lung transplantation has been associated with poor long-term clinical course and is a risk factor for chronic lung allograft dysfunction and graft loss. Appropriate management of AMR is necessary to improve graft survival in lung transplant recipients. There is currently no standardized approach to the treatment of lung AMR, and practices vary by institution. We sought to examine the efficacy of a standardized protocol of plasma exchange (PLEX) and IVIG in decreasing donor-specific antibodies (DSAs) and improving AMR in lung transplant recipients. A retrospective chart review was conducted on all lung transplant recipients who completed a course of PLEX per UT Southwestern AMR protocol between January 2012 and December 2019 for diagnosis of AMR. Data were collected on the patient clinical course, treatment regimen, pre-PLEX DSA, post-PLEX DSA, follow-up (&gt; 1-month post-PLEX) DSA, and pre-and post-PLEX biopsy, when available. Of 527 patients who underwent lung transplantation during the study period, 56 (11%) received an acute course of PLEX every other day per protocol for AMR of lung transplant. Forty (71%) of 56 patients had one episode of AMR requiring PLEX; 16 patients (29%) had repeat episodes of AMR within 6 weeks to 47 months of the first episode. Most patients showed improvement in AMR on biopsy (69%) and a decline in DSA (68%). Our data suggest that treatment with combined PLEX and IVIG protocol appears effective for treating lung AMR.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"39 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.22151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Ultrasound-Guided Cannulation Training Across Eight NHSBT Therapeutic Apheresis Units in England","authors":"Daniel Putensen,&nbsp;Samuel Ntakirutimana,&nbsp;Marc Lyon,&nbsp;Bridget Audsley,&nbsp;Nicola Newbound","doi":"10.1002/jca.22149","DOIUrl":"https://doi.org/10.1002/jca.22149","url":null,"abstract":"<div>\u0000 \u0000 <p>Ultrasound-guided cannulation (USGC) of a peripheral vein reduces the need for central vascular access device (CVAD) placement to perform a successful apheresis procedure. Effective training of healthcare professionals to acquire this skill is essential. Here, we report on the implementation of the USGC training across eight apheresis units in England. A 3-h introductory training program was devised with theoretical and practical elements. This was followed by supervised USGC practices on any patient ≥ 18 years old, regardless of venous status. Data on all supervised USGC attempts were recorded and analyzed. Over an 11-month period, 11 nurses were trained to USGC competency with another six nurses still in training, resulting in seven out of eight units having at least one USGC-competent nurse. In one unit, USGC training has not started yet. Three hundred sixty-one supervised USGC episodes on 168 patients and donors took place; of these, 178 were done for training purposes only on patients who had visible and palpable veins, 179 USGC were done on patients with difficult venous status and four were not recorded. The period from first supervised USGC to competency was a median of 45 days (Range: 17–166 days), with a median of 15 successful (Range: 10–30) and two unsuccessful (Range: 1–15) USGC being performed per trainee. The placement of 57 CVADs and 41 multiple cannulation attempts have been avoided. USGC is a useful tool to reduce the need for CVAD. Training across multiple apheresis units is a lengthy procedure, but it can be successfully implemented.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"39 5","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Plasma Exchange to Reverse Plasma Failure in Multiple Organ Dysfunction Syndrome","authors":"Matthew J. Foglia,&nbsp;Jay S. Raval,&nbsp;Jan C. Hofmann,&nbsp;Joseph A. Carcillo","doi":"10.1002/jca.22147","DOIUrl":"https://doi.org/10.1002/jca.22147","url":null,"abstract":"<p>Plasma plays a crucial role in maintaining health through regulating coagulation and inflammation. Both are essential to respond to homeostatic threats such as traumatic injury or microbial infection; however, left unchecked, they can themselves cause damage. A well-functioning plasma regulatory milieu controls the location, intensity, and duration of the response to injury or infection. In contrast, plasma failure can be conceptualized as a state in which these mechanisms are overwhelmed and unable to constrain coagulation and inflammation appropriately. This dysregulated state causes widespread tissue damage and multiple organ dysfunction syndrome. Unlike plasma derangements caused by individual factors, plasma failure is characterized by a heterogeneous set of plasma component deficiencies and excesses. Targeted therapies such as factor replacement or recombinant antibodies are thus inadequate to restore plasma function. Therapeutic plasma exchange offers the unique ability to remove harmful factors and replete exhausted components, thereby reestablishing appropriate regulation of coagulation and inflammation.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"39 5","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.22147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142449041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Uniform Apheresis Case Report Form for Standardized Collection of Apheresis Data","authors":"Andrew D. Johnson,&nbsp;Zbigniew M. Szczepiorkowski,&nbsp;Rasheed A. Balogun,&nbsp;Oliver Karam,&nbsp;Marianne Nellis,&nbsp;Jennifer Schneiderman,&nbsp;Joseph Schwartz,&nbsp;Jeffrey L. Winters,&nbsp;Yanyun Wu,&nbsp;Tomas Armendariz,&nbsp;Edwin Burgstaler,&nbsp;Laura Collins,&nbsp;Kira Geile,&nbsp;Katerina Pavenski,&nbsp;Amber P. Sanchez,&nbsp;Volker Witt,&nbsp;Amutha Muthusamy,&nbsp;Thomas Pederson,&nbsp;Vidhyalakshmi Ramesh,&nbsp;Mai Thao,&nbsp;Therese Chlebeck,&nbsp;Nicole D. Zantek","doi":"10.1002/jca.22146","DOIUrl":"https://doi.org/10.1002/jca.22146","url":null,"abstract":"<p>Apheresis is performed worldwide for an increasing number of indications. The development of common data elements (CDE) for apheresis related areas may facilitate conduct of new research, enhance quality initiatives including benchmarking, and improve patient care. This report describes the systematic development of the Uniform Apheresis Case Report Form (UACRF) as part of the Apheresis in the United States (ApheresUS) program. A consensus panel of 17 diverse experts in apheresis, related specialties, and electronic case report form (eCRF), and database development was assembled. The panel met via online conferencing from November 17, 2020 to December 1, 2021. A draft document was posted online for public comment from October 11, 2021 to November 10, 2021. Feedback was collected using an online survey tool. The consensus panel revised the UACRF. This version was converted to an eCRF with additional changes made to improve usability in this format. The final version of the UACRF was created on August 24, 2023. The UACRF contains 16 modules: procedure and subject eligibility, patient demographics, general procedure information, laboratory parameters, vascular access, common procedure elements, eight procedure specific modules (mononuclear cell collection and seven therapeutic modalities), outcomes, and site information. A total of 137 data elements were created, including 57 with one or more subelements. The UACRF is the first systematic attempt to develop CDE for therapeutic apheresis and white blood cell collections. Further validation of the UACRF is necessary to confirm the tool's ability to collect the relevant data elements and determine the usability of the form.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"39 5","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.22146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preemptive Approach to Plerixafor Use Is Optimal in Patients With Relapsed/Refractory Germ Cell Tumors Undergoing Peripheral Blood Hematopoietic Stem Cell Collection: Effect on Collection Days, Yields, and Cost","authors":"David O. Sohutskay,&nbsp;Anne M. Tetrick,&nbsp;W. Scott Goebel,&nbsp;Dave Schwering,&nbsp;Manasa S. Reddy","doi":"10.1002/jca.22145","DOIUrl":"https://doi.org/10.1002/jca.22145","url":null,"abstract":"<p>Evidence describing the use of plerixafor in the off-label population of relapsed/refractory germ cell tumors (GCT) is limited. We aim to describe the effect of rescue versus preemptive plerixafor use on apheresis collection days, collection yields, and cost. We retrospectively collected data on 77 consecutive patients (at least 15 years of age) with GCT who underwent peripheral blood stem cell (PBSC) collection for autologous stem cell transplant between January 1, 2020 and May 1, 2022. Depending on insurance approval, plerixafor was given either as “rescue” (after a first apheresis collection of &lt; 5 × 10⁶ CD34+ cells/kg) or as “preemptive” on Day 4 of granulocyte-colony stimulating factor (G-CSF) prior to the first apheresis collection, if the Day 4 peripheral blood CD34+ count was &lt; 40 cells/μL. A total of 66% of patients who received preemptive plerixafor completed collection in 1 day, similar to good mobilizers who only needed G-CSF (71%, <i>p</i> = 0.366). In contrast, all poor mobilizers in the rescue group required at least 2 days of collection and had lower CD34+ cell yields than the preemptive group (7.15 vs. 9.81 × 10⁶/kg, <i>p</i> = 0.0055). A cost analysis revealed that preemptive plerixafor may save approximately $7000 per patient compared with a rescue approach. Preemptive plerixafor in GCT patients undergoing PBSC collection allows relatively poor mobilizers to collect in fewer days and with lower overall cost. Fewer apheresis procedures result in less risk to the patient, increased patient satisfaction, and the ability to schedule more patients within the constraints of staffing.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"39 5","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.22145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}