Balint Bela, Ostojic Gordana, Pavlovic Mirjana, Hrvacevic Rajko, Pavlovic Miodrag, Tukic Ljiljana, Radovic Milan
Department of Experimental Hematology, Institute for Medical Research, Belgrade, Serbia and Montenegro.
Transfus Apher Sci. 2006 Aug;35(1):25-31. doi: 10.1016/j.transci.2006.03.001. Epub 2006 Aug 28.
This report presents our experience with cytaphereses performed in treatment of 476 patients. Leukapheresis was used in management of 68 patients with hyperleukocytosis leukostasis (WBC > or = 150 x 10(9)L(-1)). Average decrease in cell count after treatment was 73.3%. Plateletapheresis for 32 patients (platelets > or = 1500 x 10(9)L(-1)) was applied in order to prevent the thrombotic-hemorrhagic syndrome and resulted in a moderate platelet count reduction (84.3%). Erythrocytaphereses performed in treatment of 376 patients by manual or automated technique resulted in a rapid blood viscosity drop (42.4+/-7.1%). Patients with red blood cell exchanges (severe malaria and autoimmune hemolytic crisis) were in life-threatening situations and resulted in a prompt reduction of parasitized or antibody-coated RBCs and anemia correction. This study indicates that "conventional" TCs resulted in considerable cytoreduction only in patients with especially high cell count. This effect was not associated with bone marrow remission. The best clinical effect and long-term benefits were obtained using RBCX and antimalarial drugs in malaria patients who have had high-level parasitized-RBCs with multiorgan dysfunction.
本报告介绍了我们对476例患者进行血细胞分离术的经验。白细胞单采术用于治疗68例高白细胞血症性白细胞淤滞（白细胞计数≥150×10⁹/L）患者。治疗后细胞计数平均下降73.3%。对32例血小板计数≥1500×10⁹/L的患者进行血小板单采术，以预防血栓-出血综合征，结果血小板计数适度降低（84.3%）。采用手动或自动技术对376例患者进行红细胞单采术，导致血液粘度迅速下降（42.4±7.1%）。进行红细胞置换术的患者（重症疟疾和自身免疫性溶血危象）处于危及生命的状况，结果使寄生或被抗体包被的红细胞迅速减少，贫血得到纠正。本研究表明，“传统”血细胞分离术仅在细胞计数特别高的患者中导致显著的细胞减少。这种效应与骨髓缓解无关。在患有高水平寄生红细胞且伴有多器官功能障碍的疟疾患者中，使用红细胞置换术和抗疟药物可获得最佳临床效果和长期益处。
