Out with the bad and in with the good; red cell exchange, white cell reduction, and platelet reduction.
Automated techniques for red cell [red blood cell (RBC)] exchange or depletion of malignant cells from the peripheral blood have allowed patients with life-threatening conditions to survive long enough to receive definitive treatment. Examples of such conditions include acute chest syndrome in sickle cell disease (SCD) or acute respiratory insufficiency due to leukostasis in acute leukemia. Conversely, other patients with SCD undergo RBC exchanges on a chronic basis to maintain a reasonable quality of life and prevent another stroke. In this review, we will discuss the techniques as well as indications for RBC exchange, leukocytapheresis, and thrombocytapheresis. To illustrate the uses of these therapeutic apheresis procedures, the authors included a summary of the most common diagnoses that comprise their use.
Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama.
Marisa B
MB
Marques
Nirupama
N
Singh
Vishnu V B
VV
Reddy
D000755:Anemia, Sickle Cell / Q000150:complications / Q000628:therapy; D001404:Babesiosis / Q000628:therapy; D001781:Blood Component Removal / Q000379:methods; D001792:Blood Platelets; D001853:Bone Marrow / Q000473:pathology; D017707:Erythrocyte Transfusion; D006453:Hemoglobinopathies / Q000235:genetics / Q000628:therapy; D006579:Heterozygote; D006801:Humans; D047589:Leukocyte Reduction Procedures; D007964:Leukocytosis / Q000628:therapy; D008288:Malaria / Q000628:therapy; D009102:Multiple Organ Failure / Q000209:etiology / Q000517:prevention & control; D009336:Necrosis; D009360:Neoplastic Cells, Circulating; D018512:Parasitemia / Q000628:therapy; D012805:Sickle Cell Trait / Q000150:complications / Q000628:therapy; D013922:Thrombocytosis / Q000628:therapy
hyperleukocytosis; leukocytapheresis; red blood cell exchange; sickle cell disease; thrombocytapheresis; thrombocytosis