ABSTRACT
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.
The medical registry of Ankara University Faculty of Medicine Therapeutic Apheresis Unit was retrospectively reviewed for TTA procedures between January 1999 and December 2020.
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].
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