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Inicio Medicina Clínica (English Edition) Therapeutic erythroapheresis: Experience in patients with polycythemia vera and ...
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Vol. 154. Issue 1.
Pages 16-19 (January 2020)
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Vol. 154. Issue 1.
Pages 16-19 (January 2020)
Brief report
Therapeutic erythroapheresis: Experience in patients with polycythemia vera and secondary erythrocytosis
Eritroaféresis terapéutica: experiencia en pacientes con policitemia vera y eritrocitosis secundaria
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Ingrid Parra Salinasa, Valle Recasens Floresa, María Ángeles Montañésa, José Antonio García-Erceb,c,
Corresponding author
jagarciaerce@gmail.com

Corresponding author.
a Servicio de Hematología y Hemoterapia, Hospital Miguel Servet, Zaragoza, Spain
b Banco de Sangre y Tejidos de Navarra, Pamplona, Spain
c Grupo de Trabajo de la Sociedad Española de Transfusión Sanguínea «Hemoterapia basada en sentido común», Spain
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Table 1. The sample's main characteristics.
Table 2. Distribution of the variables according to the response.
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Abstract

Therapeutic erythrocytapheresis (TE) is a more efficient strategy compared to phlebotomy to deplete levels of haematocrit in primary and secondary erythrocytosis.

Objective

To analyse response rate and safety profile of TE in polycythemia vera (PV) and secondary erythrocytosis (SE).

Patients and method

Retrospective review of all patients with PV or SE treated with TE, due to phlebotomy failure, or comorbidities that prevented changes of blood volume.

Results

217 TE sessions (48 PV and 79 SE) corresponding to 20 patients (12 ES and 8 PV). Response was achieved in 87.5% of PV patients and in 50% of SE patients. Adverse effects related to TE performance occurred in 7.08%.

Conclusion

Despite our small sample size and the heterogeneous nature of the patients included, we can postulate that TE is a secure strategy that can achieve haematocrit depletion in a shorter time than phlebotomy, specifically in PV patients and in selected cases of SE with expected haemodynamic intolerance to phlebotomies or in patients who fail to respond to phlebotomies.

Keywords:
Therapeutical apheresis
Erythrocytapheresis cytapheresis
Polycythemia vera
Erythrocytosis
Safety
Resumen

La eritrocitaféresis terapéutica (ET) es una estrategia más eficiente que la flebotomía en la reducción del hematocrito en las eritrocitosis primarias y secundarias.

Objetivo

Analizar la tasa de respuesta y seguridad de la ET en policitemia vera (PV) y eritrocitosis secundaria (ES).

Pacientes y método

Revisión retrospectiva de los pacientes con PV o ES tratados con ET, ante el fracaso a flebotomías o con comorbilidades que impedían cambios importantes de volemia.

Resultados

Se realizaron 127 sesiones de ET (48 PV y 79 ES) en 20 pacientes (12 ES y 8 PV). La respuesta se obtuvo en el 87,5% de PV y en el 50% de ES. La tasa de complicaciones fue del 7,08%.

Conclusiones

A pesar del tamaño de nuestra muestra y la heterogeneidad clínica de nuestra serie, podemos postular que la ET reduce de manera segura los valores de hematocrito en menor tiempo que la flebotomía, especialmente en pacientes con PV y en casos seleccionados de ES en quienes se prevé intolerancia hemodinámica a la flebotomía o en quienes falla este método.

Palabras clave:
Eritrocitaféresis terapéutica
Aféresis
Policitemia vera
Eritrocitosis
Seguridad

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