Journal of Clinical Apheresis最新文献

{"title":"Correction to “Therapeutic Plasma Exchange for Complicated Hyperthyroidism: A Case Series”","authors":"","doi":"10.1002/jca.70180","DOIUrl":"10.1002/jca.70180","url":null,"abstract":"<p>\u0000 <span>H. H. Phan</span>, <span>T. Q. Lam</span>, and <span>M. D. Do</span>, “ <span>Therapeutic Plasma Exchange for Complicated Hyperthyroidism: A Case Series</span>,” <i>Journal of Clinical Apheresis</i> <span>41</span>, no. <span>4</span> (<span>2026</span>): e70171, https://doi.org/10.1002/jca.70171.\u0000 </p><p>The affiliation 2 of the author Minh Duc Do “Center for Molecular Biomedicine, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam” was incorrect. This should have read “Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam.”</p><p>We apologize for this error.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"41 5","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968677","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":"The Optimal Therapeutic Window for Nonbioartificial Liver Support in Acute-On-Chronic Liver Failure: A Meta-Analysis and Meta-Regression Based on Baseline MELD Score","authors":"Jiahao Li,&nbsp;Yang Liu,&nbsp;Jianying Shao,&nbsp;Yali Cheng,&nbsp;Xiangkai Zeng,&nbsp;Han Li,&nbsp;Haoqian Tan,&nbsp;Junying Liu","doi":"10.1002/jca.70177","DOIUrl":"10.1002/jca.70177","url":null,"abstract":"<div>\u0000 \u0000 <p>NBALS efficacy in ACLF remains controversial. We aimed to determine if a “therapeutic window” exists by stratifying clinical outcomes based on baseline Model for End-Stage Liver Disease (MELD) scores. We searched PubMed, Embase, Cochrane Library, and Web of Science for RCTs and PSM-cohorts comparing NBALS to standard medical therapy (SMT). Primary outcome was 28-day mortality; MELD-stratified subgroup analyses and random-effects meta-regression were performed. Eleven studies (comprising 12 datasets) involving 1958 patients (991 NBALS vs. 967 SMT) were included. Overall, NBALS significantly reduced 28-day mortality compared with SMT (pooled RR 0.72, 95% CI [0.63–0.83], <i>I</i>² = 2.8%). Subgroup analysis suggested a clinical trend toward a distinct therapeutic window: the survival benefit was most significant in the Intermediate MELD group (25–30) (RR 0.65, 95% CI [0.52–0.81], <i>I</i>² = 0%) and the High MELD group (&gt; 30) (RR 0.75, 95% CI [0.58–0.98], <i>I</i>² = 0%), while substantial uncertainty exists regarding the survival benefit in the Low MELD group (&lt; 25) (RR 0.49, 95% CI [0.08–2.81], <i>I</i>² = 67.9%). Meta-regression confirmed that the maximum survival benefit of NBALS is concentrated within a baseline MELD range of approximately 25 to 32. Furthermore, NBALS group achieved a significantly higher reduction in total bilirubin compared to SMT (pooled MD 98.15, 95% CI [66.50–129.79], <i>I</i>² = 99.2%). NBALS significantly improves short-term survival in ACLF, suggesting a potential therapeutic window around a baseline MELD range of 25–32. Early stratification based on disease severity is crucial for optimizing NBALS application.</p>\u0000 <p><b>Trial Registration:</b> PROSPERO CRD420261334987.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"41 5","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968658","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":"Evolution of Therapeutic Plasma Exchange Use and Outcomes in Children Across American Society for Apheresis Categories: A Single-Center Cohort Study","authors":"Giovanni Ceschia,&nbsp;Ana C. Navarro,&nbsp;Kelli A. Krallman,&nbsp;Stuart L. Goldstein","doi":"10.1002/jca.70175","DOIUrl":"10.1002/jca.70175","url":null,"abstract":"<div>\u0000 \u0000 <p>To characterize pediatric TPE utilization, safety, treatment response, and mortality across American Society for Apheresis (ASFA) categories and over time. Retrospective single-center cohort study of patients aged 0–25 years who underwent therapeutic plasma exchange (TPE) between 2011 and 2024. Primary outcomes included TPE utilization, temporal trends, and procedure-related complications. Secondary outcomes included treatment response according to indication-specific criteria and 28-day mortality overall and by ASFA category. A total of 416 TPE courses were performed in 384 patients (median age 10 years, IQR 2–16). TPE utilization increased over time (Spearman <i>ρ</i> = 0.88; <i>p</i> &lt; 0.001), with ASFA Category II and III indications accounting for approximately 80% of courses throughout the study period. Procedure-related complications occurred in 76 of 3640 procedures (2%) and were more frequent in Category III than Categories I and II (3% vs. 1% and 2%; <i>p</i> &lt; 0.001). Rates of treatment goal achievement were similar across ASFA categories (84.0% in Category I, 84.8% in Category II, and 75.4% in Category III; <i>p</i> = 0.11). Overall, 28-day mortality was 13%, including 4% in Category I, 6% in Category II, and 24% in Category III (<i>p</i> &lt; 0.001). In Category III indications, treatment during 2018–2024 was associated with lower adjusted odds of 28-day mortality compared with 2011–2017 (aOR 0.33; 95% CI 0.13–0.83; <i>p</i> = 0.02). TPE use in our single center has expanded substantially, particularly for lower-evidence indications. Despite this shift, TPE remains safe and is associated with similar response rates across categories. Improved adjusted survival over time was observed in Category III.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"41 5","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906358","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":"Predicting Non-Target Neutrophil Collection During HPC(A): Implications for Research Protocols in Apheresis","authors":"Yandy Marx Castillo-Aleman,&nbsp;Carlos Agustin Villegas-Valverde,&nbsp;Yendry Ventura-Carmenate,&nbsp;Shinnette Lumame,&nbsp;Jay Mary Rose-Roque,&nbsp;Marlene Cato,&nbsp;Hamda Ali,&nbsp;Ruaa Mousa Ali,&nbsp;Rachely Hernandez-Corrales,&nbsp;Anil Sarode,&nbsp;Yaima Zuñiga-Rosales,&nbsp;Vianed Marsan-Suarez,&nbsp;Antonio Alfonso Bencomo-Hernandez","doi":"10.1002/jca.70174","DOIUrl":"https://doi.org/10.1002/jca.70174","url":null,"abstract":"<div>\u0000 \u0000 <p>Neutrophils are unintentionally co-collected during HPC(A) procedures using mononuclear cell collection protocols. Although non-target granulocyte co-collection is generally clinically acceptable, excessive neutrophil content may compromise certain translational research applications. This study aimed to develop a predictive model for neutrophil yield during routine HPC(A). A retrospective single-center analysis of 377 HPC(A) procedures performed between January 2023 and April 2026 was conducted. Donor demographics, hematological parameters, procedural characteristics, and collection efficiency (CE) metrics were analyzed. Correlations between CE₁ and CE₂ were evaluated using Spearman's rank correlation coefficient. A multivariable linear regression model incorporating pre-apheresis neutrophil count, processed blood volume (pBV), and neutrophil CE₁ was developed to predict neutrophil apheresis yield. Model performance was assessed using <i>R</i>², RMSE, MAE, Bland–Altman analysis, and 5-fold cross-validation. Strong positive correlations were observed between CE₁ and CE₂ for both CD34⁺ cells (<i>ρ</i> = 0.836, <i>p</i> &lt; 0.0001) and neutrophils (<i>ρ</i> = 0.865, <i>p</i> &lt; 0.0001). In contrast, the multivariate regression model demonstrated only modest predictive performance for neutrophil yield (<i>R</i>² = 0.198). Compared with the conventional fixed CE₁ approach, the regression-based model showed lower RMSE, reduced systematic bias, and improved agreement between predicted and observed neutrophil yields on Bland–Altman analysis. Neutrophil yield during HPC(A) can be estimated using a regression model that integrates pre-apheresis neutrophil count, pBV, and CE₁. Although predictive performance remains modest, regression-based approaches improve estimation accuracy compared with simplified fixed CE models and may support procedural planning and translational research applications involving non-target granulocyte co-collection in HPC(A) products.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"41 5","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860188","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 Complicated Hyperthyroidism: A Case Series","authors":"Hen Huu Phan,&nbsp;Thien Quoc Lam,&nbsp;Minh Duc Do","doi":"10.1002/jca.70171","DOIUrl":"10.1002/jca.70171","url":null,"abstract":"<div>\u0000 \u0000 <p>Therapeutic plasma exchange is a second-line therapy for severe hyperthyroidism when anti-thyroid drugs (ATD) are contraindicated or ineffective. We report five patients (three males, two females, age range: 30–70 years old): ATD-induced agranulocytosis (<i>n</i> = 2); ATD-induced cholestatic hepatitis (<i>n</i> = 1); refractory hyperthyroidism with large goiter (<i>n</i> = 1); thyroid storm during pregnancy (<i>n</i> = 1). A total of six TPE sessions were performed (five with fresh frozen plasma, one with 5% albumin). Among sessions with quantifiable baseline fT4, levels decreased by a mean of 39.0% per session; two sessions had baseline fT4 above the assay's upper limit of quantification, precluding exact calculation, though both showed reductions of at least 50%. Four patients underwent successful thyroidectomy; one continued medical management. No intraoperative thyroid storms occurred. TPE could be an effective bridging strategy for patients with severe hyperthyroidism and ATD intolerance.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"41 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761332","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":"Angiotensin Converting Enzyme Polymorphism in Prior Anaphylactoid Reaction to Lipoprotein Apheresis","authors":"Beatrice Dal Pino,&nbsp;Francesco Sbrana","doi":"10.1002/jca.70168","DOIUrl":"10.1002/jca.70168","url":null,"abstract":"","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"41 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720882","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":"The Impact of Donor RBC Storage Duration on the Efficacy of Chronic RBC Exchange","authors":"Jaehyup Kim","doi":"10.1002/jca.70163","DOIUrl":"10.1002/jca.70163","url":null,"abstract":"<p>Red blood cells (RBCs) accumulate damage during storage, shortening their post-transfusion lifespan. For chronic RBC exchange (RBCx), fresh RBCs have been preferred because of this concern. This study assessed the impact of RBC storage time and analyzed 20 procedures using freshness-waived RBCs. The results confirmed a reduction in calculated RBC lifespan. However, the impact on hematocrit or HbS percentage was not significant. Extending RBC freshness criteria for chronic RBCx could reduce costs while maintaining similar outcomes.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"41 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673690","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":"Plasma Exchange in Myeloma-Associated Acute Kidney Injury: A Multicenter Propensity-Matched Cohort Study","authors":"Joseph O'Brien,&nbsp;Monica S. Nair,&nbsp;Niraj B. Desai,&nbsp;Robert W. Maitta,&nbsp;Timothy O'Brien","doi":"10.1002/jca.70167","DOIUrl":"10.1002/jca.70167","url":null,"abstract":"<div>\u0000 \u0000 <p>Acute kidney failure from light chain cast nephropathy is a serious complication of multiple myeloma. Plasma exchange (PLEX) has been used to remove circulating free light chains (FLCs), but its benefit in the modern treatment era remains uncertain. We performed a retrospective multicenter cohort study using the TriNetX Research Network to identify newly diagnosed multiple myeloma cases presenting between 2014 and 2024 with acute kidney failure and FLC levels &gt; 1500 mg/L. Patients were classified by receipt of PLEX within 7 days. Propensity score matching incorporated demographics, comorbidities, laboratory values, and initial myeloma-directed therapies. The primary outcome was dialysis dependence at 90 days. Secondary outcomes included dialysis dependence at 180 days, mortality, renal recovery (creatinine &lt; 2.0 mg/dL), ICU admission within 7 days, and dialysis-free survival. Among 5454 eligible patients, 251 (4.6%) received PLEX. After matching, 248 patients were included in each group. PLEX was not associated with reduced dialysis dependence at 90 (16.1% vs. 18.1%; OR 0.87, 95% CI 0.54–1.39) or 180 days (18.5% vs. 20.2%; OR 0.90, 95% CI 0.58–1.41). Mortality, ICU admission, and dialysis-free survival were also similar. PLEX was not associated with improved dialysis independence or survival, supporting rapid initiation of effective anti-myeloma therapy.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"41 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678926","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":"A Case of Vanished Buffy Coat in Peripheral Blood Hematopoietic Progenitor Cell Harvest","authors":"Daniela Zantomio,&nbsp;Ye Mon Than,&nbsp;Blerime Zeneli,&nbsp;Joy Reddrop","doi":"10.1002/jca.70164","DOIUrl":"10.1002/jca.70164","url":null,"abstract":"<div>\u0000 \u0000 <p>We report on an autologous hematopoietic progenitor cell collection via apheresis (HPC(A)) with adequate CD34+ pre-count and unexpectedly low collection efficiency resulting in a failed HPC(A) collection. The collection bag contained almost no buffy coat and the plasma was orange. We assess both collection and patient factors that may have contributed to this finding.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"41 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673717","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 Removal of Bevacizumab: A Case Series","authors":"Sooraj Srirangadhamu Gopu,&nbsp;Rushad Patell,&nbsp;Erik J. Uhlmann,&nbsp;Rafael A. Vega,&nbsp;Brian J. Carney","doi":"10.1002/jca.70166","DOIUrl":"10.1002/jca.70166","url":null,"abstract":"<div>\u0000 \u0000 <p>Bevacizumab is a humanized monoclonal antibody against vascular endothelial growth factor A. Its long half-life and low volume of distribution allow circulating drug to persist in the body for weeks, which becomes clinically relevant when urgent or emergent surgery is needed. Because bevacizumab is largely intravascular, therapeutic plasma exchange (TPE) is attractive, though published experience is limited. We describe four adults who underwent TPE to facilitate surgery or postoperative wound healing after bevacizumab exposure: two with glioblastoma multiforme (GBM) before craniotomy, one with GBM after bowel resection with primary anastomosis, and one with metastatic rectal adenocarcinoma before craniotomy for a hemorrhagic brain mass. Patients received one to three sessions with albumin replacement, with fresh frozen plasma added in one case. No postoperative hemorrhage or delayed wound healing occurred. These cases support a practical role for TPE when residual bevacizumab exposure remains relevant and awaiting spontaneous clearance is not feasible.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"41 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663999","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}