Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Institute of Hematology and Transfusion Medicine, Warsaw, Poland.
Semin Hematol. 2020 Apr;57(2):57-64. doi: 10.1053/j.seminhematol.2020.07.008. Epub 2020 Jul 25.
The early apheresis devices were developed in 1930s, but therapeutic apheresis only became widely used decades later, when automated cell separators were introduced. Progress in technical development of these devices continues to this day. Initial use of therapeutic apheresis has not been evidence based. Documents such as the Guidelines by the American Society for Apheresis provided hematologist with better tools to assess the role of therapeutic apheresis in daily practice. This review focuses on the use of therapeutic apheresis in patients with hematological disorders. Four separate apheresis modalities most encountered by hematologists are discussed: therapeutic plasma exchange, therapeutic leukocytapheresis, red blood cell exchange, and extracorporeal photopheresis. Examples of indications are provided and discussed. The future of therapeutic apheresis and its role in different diseases is undergoing continuous re-evaluation as disease pathogenesis is better understood and new treatment options become available.
早期的血浆分离设备于 20 世纪 30 年代开发，但治疗性血浆分离直到几十年后自动化细胞分离机问世才广泛应用。这些设备的技术发展至今仍在不断进步。治疗性血浆分离的最初应用并非基于证据。美国血浆分离学会的指南等文件为血液学家提供了更好的工具，以评估治疗性血浆分离在日常实践中的作用。这篇综述重点介绍了治疗性血浆分离在血液系统疾病患者中的应用。讨论了血液学家最常遇到的四种单独的血浆分离方式：治疗性血浆置换、治疗性白细胞分离、红细胞置换和体外光化学疗法。提供并讨论了适应证的例子。随着疾病发病机制的进一步了解和新的治疗选择的出现，治疗性血浆分离及其在不同疾病中的作用正在不断重新评估。
