Therapeutic apheresis in the Philippines.

The statistics for this report were obtained from a current survey being conducted by the Philippine Society for Hematology and Blood Transfusion for the purpose of organizing a national apheresis registry. Preliminary data coming from 8 of 10 medical centers included 194 patients and 735 procedures from 1994 to 2004. Eighty percent of patients belonged to ASFA indication Category I with a predominance of neurologic and hematologic disorders. Five most common indications were acute inflammatory demyelinating polyradiculoneuropathy (AIDP), multiple sclerosis (MS), thrombotic thrombocytopenic purpura (TTP), leucocytosis/thrombocytosis (L/T), and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). A rise from 5% to 20% was noted in procedures for TTP in this 10-year period. Favorable response is noted in the use of therapeutic apheresis (TA) for the removal of antibodies in presensitized patients prior to kidney transplantation to prevent rejection. Complete recovery was seen in 2 of 4 patients with fulminant hepatic failure. Two patients with idiopathic thrombocytopenia (ITP) treated by plasma exchange were classified under Category IV due to unavailability of affinity columns. Negative results reported in controlled studies for the treatment of systemic lupus erythematosus account for the limited use of TA in this disease. Factors affecting the progress of TA in the country were cited. The organization of a national registry for apheresis may improve the practice of TA in the Philippines.