Therapeutic apheresis in hematopoietic cell transplantationNina Worel1, Gerda Leitner1, Andrea Wagner1, Hildegard T Greinix2, Paul Höcker1, Peter Kalhs21Department For Blood Group Serology And Transfusion Medicine, Medical University Of Vienna, Austria
2First Medical Department, Bone Marrow Transplantation
With the introduction of hematopoietic stem cell transplant (HSCT), transplant-associated problems like graft-versus-host disease (GVHD) and transplant-associated microangiopathy (TAM) have occurred. In addition, approximately 40% of allogeneic HSCTs are performed across the ABO blood group barrier, bearing the risk for immunohematological complications like severe hemolysis and pure red cell aplasia (PRCA). All these problems can potentially require therapeutic apheresis. In this review, we address recent developments in therapeutic apheresis for patients undergoing allogeneic HSCT for prevention or treatment of hemolysis in minor ABO-incompatible transplantation, treatment of PRCA after major ABO-incompatible transplantation, and treatment of TAM and GVHD. Keywords: Stem cell transplantation, therapeutic apheresis, hemolysis, pure red cell aplasia, thrombotic microangiopathy, graft-versus-host disease
Hematopoetik kök hücre transplantasyonunda terapotik aferezNina Worel1, Gerda Leitner1, Andrea Wagner1, Hildegard T Greinix2, Paul Höcker1, Peter Kalhs21Department For Blood Group Serology And Transfusion Medicine, Medical University Of Vienna, Austria
2First Medical Department, Bone Marrow Transplantation
Hematopoetik kök hücre transplantasyonunun uygulanmasıyla Graft-versus-host hastalığı (GVHH) gibi transplanta bağlı problemler ve transplanta bağlı mikroanjiyopati (TAM) ortaya çıkmıştır. Ayrıca, allojenik HSCT’lerin yaklaşık %40’ı, şiddetli hemoliz ve saf kırmızı hücre aplazisi (PRCA) gibi immünohematolojik komplikasyon riski taşıyan ABO kan grubu karşın gerçekleştirilmiştir. Tüm bu problemler potansiyel olarak terapötik aferez gerektirebilir. Minör ABO uyumsuz transplantasyonda hemolizin tedavisi veya önlenmesi, majör ABO uyumsuz transplantasyon sonrası PRCA tedavisi ve TAM ve GVHH tedavisi için allojeneik HKHT uygulanan hastalara yönelik terapötik aferez ile ilgili en son gelişmeler bu değerlendirmede ele alınmaktadır. Anahtar Kelimeler: Kök hücre transplantasyonu, terapötik aferez, hemoliz, saf kırmızı hücre aplazisi, trombotik mikroanjiyopati, graft-versus host hastalığı
Nina Worel, Gerda Leitner, Andrea Wagner, Hildegard T Greinix, Paul Höcker, Peter Kalhs. Therapeutic apheresis in hematopoietic cell transplantation. Turk J Hematol. 2008; 25(4): 164-171
Corresponding Author: Nina Worel, Austria |
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