Therapeutic plasma exchange in the immune hemolytic anemias and immunologic thrombocytopenic purpura.

Thus, plasma exchange appears to have a potential but limited role in the care of antibody mediated injury of red cells or platelets. Its clearest indication appears to be in those uncommon instances of warm antibody mediated hemolysis with a highly fulminant course where the classical therapeutic measures do not have adequate time for effect. Similarly, such therapy appears to have significant potential in cases of acute immunologic thrombocytopenic purpura where some clinical contraindication to steroids, immunosuppressive agents or splenectomy exists. Acute ITP of pregnancy may provide another important setting for such a therapeutic approach. Finally, plasma exchange has been shown to provide temporary clinical stability in cases of chronic cold agglutinin disease.