Korkmaz Gulten, Dagdas Simten, Saltoglu Tugce, Ceran Funda, Aydın Muruvvet Seda, Bektas Hesna, Subutay Nese, Dilek Imdat, Ozet Gulsum
Department of Hematology, Ankara Bilkent City Hospital, Ankara, Turkey.
Department Of Neurology, Ankara Bilkent City Hospital, Ankara, Turkey.
Ther Apher Dial. 2025 Apr;29(2):312-320. doi: 10.1111/1744-9987.14223. Epub 2024 Nov 5.
Therapeutic plasma exchange has been a well-known treatment method for many years and is widely available. It leads to the improvement of neurological symptoms in autoimmune neurological diseases by the removal of antibodies. The aim of this study was to present therapeutic plasma exchange responses and procedure-related adverse events in patients with autoimmune neurological diseases based on our 11-year experience.
A retrospective evaluation was conducted on adult patients who underwent a therapeutic plasma exchange procedure due to neurological diseases between January 2013 and January 2024. Data were gathered from electronic and written hospital and apheresis unit records.
A total of 265 patients underwent 1274 procedures with a preliminary diagnosis of autoimmune neurological disease. Five patients were excluded from the analysis due to their final diagnoses. The most common clinical indications were Guillain-Barré syndrome (45.4%), myasthenia gravis (26.1%), and multiple sclerosis (19.2%). The overall response rate was 81.3%, with 21.7% exhibiting a complete response and 59.6% demonstrating a partial response. With the exception of one patient (hypertensive crisis), no complications necessitating the termination of the procedure were observed. The most prevalent complication was an easily manageable allergic reaction.
Therapeutic plasma exchange has been demonstrated to be an efficacious and safe treatment option in autoimmune neurological diseases, with a favorable overall response rate and a manageable mild-to-moderate side effect profile.
治疗性血浆置换作为一种广为人知的治疗方法已存在多年，且应用广泛。它通过清除抗体来改善自身免疫性神经疾病的神经症状。本研究旨在基于我们11年的经验，呈现自身免疫性神经疾病患者的治疗性血浆置换反应及与操作相关的不良事件。
对2013年1月至2024年1月因神经疾病接受治疗性血浆置换的成年患者进行回顾性评估。数据收集自医院电子和书面记录以及血液成分分离科室记录。
共有265例患者接受了1274次治疗性血浆置换，初步诊断为自身免疫性神经疾病。5例患者因最终诊断被排除在分析之外。最常见的临床指征是吉兰 - 巴雷综合征（45.4%）、重症肌无力（26.1%）和多发性硬化症（19.2%）。总体缓解率为81.3%，其中21.7%表现为完全缓解，59.6%表现为部分缓解。除1例患者（高血压危象）外，未观察到需要终止操作的并发症。最常见的并发症是易于处理的过敏反应。
治疗性血浆置换已被证明是自身免疫性神经疾病一种有效且安全的治疗选择，总体缓解率良好且副作用为轻度至中度，易于处理。
