Objectives:
Therapeutic thrombocytapheresis (TTA), also known as platelet depletion, is used for rapid cytoreduction in symptomatic patients or prophylaxis of high-risk patients with extreme thrombocytosis. In this paper, we present our center’s nearly 20-year experience with TTA.
Materials and Methods:
The medical registry of Ankara University Faculty of Medicine Therapeutic Apheresis Unit was retrospectively reviewed for TTA procedures between January 1999 and December 2020.
Results:
One hundred and ninety-six TTA procedures were applied to 90 patients, including 46 (51.1%) males and 44 (48.9%) females. The median age was 52.5 years (18-83). Seventy-four (82.2%) patients with essential thrombocytosis, 5 (5.6%) with chronic myeloid leukemia, 5 (5.6%) with primary myelofibrosis, 3 (3.3%) with thrombosis in acute phase and 3 (3.3%) with others were treated. 61 (67.8%) patients had initial platelet count as <1,500x109/L, 29 (32.2%) patients ≥1,500x109/L. The median initial platelet count was 1,230x109/L (545-3,825x109/L). Thirty-three (36.7%) patients required >1 TTA procedures. The decrease of platelet count was 571.5x109/L (72-3,128x109/L) and 47.5% (6.2-92.4). After TTA, the PLT count was ≤450x109/L in 19 (21.1%) patients, 450-1,000x109/L in 56 (62.2%) patients, and≥1,000 x109/L in 15 (16.7%) patients. The patients were divided into two groups according to initial platelet count. The decrease in platelet count was significantly higher in the group with PLT ≥1,500x109/L [477x109/L (72-1,644) vs 1,142x109/L (363-3,128), respectively, p=0.001]. The rate of reduction was similar [46.1% (6.2-92.4) vs 50.9% (18.3-89.2), respectively, p=0.097].
Conclusion:
TTA can provide rapid reduction of platelet count and is suitable for patients with acute serious thrombotic or hemorrhagic events or high-risk patients with very high platelet counts.
Keywords: Therapeutic Thrombocytapheresis, Thrombocytosis, Cytoreduction
