Alzheimer's Research Group, Grifols S.A., Barcelona, Spain.
Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Ther Apher Dial. 2023 Oct;27(5):949-959. doi: 10.1111/1744-9987.14002. Epub 2023 May 21.
Little is known about the impact of plasma exchange (PE) on clinical laboratory parameters in Alzheimer's disease (AD) patients.
AD patients in the AMBAR trial (N = 322) received weekly therapeutic PE (TPE) for 6 weeks followed by monthly low-volume PE (LVPE) for12 months. Treatment were placebo (sham PE), low-albumin, low-albumin + IVIG (i.e., albumin alternated with intravenous immunoglobulin) and high-albumin + IVIG.
Coagulation parameters transiently increased post-TPE. Blood calcium, platelets, and albumin levels decreased but remained within the reference range. Leukocyte counts increased. Fibrinogen, hemoglobin, total protein, gamma globulin, and IgG, transiently dipped below the reference range. Hypogammaglobulinemia (7.2 g/L) persisted in pre-TPE measurements. No changes were observed during the LVPE period. Cerebrospinal fluid parameters and vital signs were unchanged throughout.
Laboratory parameters of AD patients were affected by TPE similarly to effects of PE-treatment for other pathologies. These effects were less pronounced or non-existent for LVPE.
关于血浆置换 (PE) 对阿尔茨海默病 (AD) 患者临床实验室参数的影响知之甚少。
AMBAR 试验中的 AD 患者（N=322）接受每周一次的治疗性 PE（TPE）治疗 6 周，随后每月进行低容量 PE（LVPE）治疗 12 个月。治疗方案为安慰剂（假 PE）、低白蛋白、低白蛋白+IVIG（即白蛋白与静脉免疫球蛋白交替使用）和高白蛋白+IVIG。
TPE 后凝血参数短暂升高。血钙、血小板和白蛋白水平降低，但仍在参考范围内。白细胞计数增加。纤维蛋白原、血红蛋白、总蛋白、γ球蛋白和 IgG 短暂低于参考范围。在 TPE 前的测量中仍存在低丙种球蛋白血症（7.2g/L）。在 LVPE 期间未观察到变化。整个过程中脑脊液参数和生命体征均无变化。
AD 患者的实验室参数受 TPE 的影响与其他疾病的 PE 治疗效果相似。对于 LVPE，这些影响不太明显或不存在。
