Clinical application of therapeutic hemapheresis

Hemapheresis has been used in a variety of clinical states, primarily for its ability to remove an offending component, likely be either plasma or cellular elements. We have reviewed 43 cases of therapeutic hemapheresis over the past two years at Veterans General Hospital. There were 20 cases of plasmapheresis, 7 cases of leukapheresis and 16 cases of thrombocytapheresis. Most of them had satisfactory and desirable effects except a few cases in therapeutic plasmapheresis. Among 20 cases of therapeutic plasmapheresis, all but 2 cases of systemic lupus erythrematosus had transient clinical improvement. Average decrease of leukocyte count in 11 procedures of leukemic patients was 37%. As for the myeloproliferative disorders with thrombocytosis, the average drop of platelet count was 41%. The side effects of therapeutic hemapheresis were not infrequent. There were 56 recorded side effects with one sudden death among 94 procedures. Hemapheresis is useful in certain clinical conditions but more judicious application should be considered.