2_plasmapheresis in hematology

PLASMAPHERESIS IN HEMATOLOGY
PLASMAPHERESIS
INDICATIONS
CONTRAINDICATIONS
CRITERIA OF EFFICIENCY
IN PARAPROTEINEMIC HEMOBLASTOSIS
Paraproteinemic hemoblastosis is a group of diseases characterized by monoclonal proliferation of immunoglobulins, to which, first of all, belong hyperparaproteinemia; hyperviscose syndrome (with a level of monoclonal protein Ig G or Ig A over 50 g/l), paraproteinemic coma, osteoporosis and osteolysis, (accumulation of myelomic protein and amyloid in Waldenstroem’s macroglobulinemia, due to the high content of immunoglobulin M, as well as to For more information visit our web site: www.plasmatech-fzc.com or contact us by e-mail: [email protected] PLASMAPHERESIS IN HEMATOLOGY
PLASMAPHERESIS
INDICATIONS
CONTRAINDICATIONS
CRITERIA OF EFFICIENCY
IN PATIENTS WITH APLASTIC ANEMIA
(IN CASE OF SENSIBILIZATION AND
REFRACTORINESS TO TRANSFUSION)
Aplastic anemia (ApAn is a disease characterized by deep pancytopenia and insufficiency of medullar hematopoiesis conditioned by development of The given nosology calls for frequent and sensibilization. In its turn, allosensibilization causes refractoriness to the transfused components of For more information visit our web site: www.plasmatech-fzc.com or contact us by e-mail: [email protected] PLASMAPHERESIS IN HEMATOLOGY
PLASMAPHERESIS
INDICATIONS
CONTRAINDICATIONS
CRITERIA OF EFFICIENCY
IN THE TREATMENT OF PORPHYRIA
Plasmapheresis (PA) is used for integral treatment of porphyria in the period of exacerbation, basically when fighting such its forms as acute intermittent porphyria and porphyria cutanea. For more information visit our web site: www.plasmatech-fzc.com or contact us by e-mail: [email protected] PLASMAPHERESIS IN HEMATOLOGY
PLASMAPHERESIS
INDICATIONS
CONTRAINDICATIONS
CRITERIA OF EFFICIENCY
IN ANTIPHOSPHOLIPID SYNDROME
Plasmapheresis (PA) is used for integral syndrome (APhS) in the period of exacerbation. For more information visit our web site: www.plasmatech-fzc.com or contact us by e-mail: [email protected] PLASMAPHERESIS IN HEMATOLOGY
PLASMAPHERESIS
INDICATIONS
CONTRAINDICATIONS
CRITERIA OF EFFICIENCY
IN HEMATOGENIC THROMBOPHILIAS
themselves by the hypercoagulation syndrome in case of availability of determined defects of cellular and plasmatic elements of blood that bring about This occurs under deficit of AT III, anomaly of the system of protein С and protein S, with mutant V methylentetrahydrofolate-reductase (MTHFR) and G202210А, mutations of integrins, presence of lupus anticoagulant - autoantibodies to phospholipids, thrombocytes - the "sticky thrombocytes" syndrome, multidimensionality of the Willebrand factor, activity of the factor VIII, high level of the factor XIII of the For more information visit our web site: www.plasmatech-fzc.com or contact us by e-mail: [email protected] PLASMAPHERESIS IN HEMATOLOGY
PLASMAPHERESIS
INDICATIONS
CONTRAINDICATIONS
CRITERIA OF EFFICIENCY
IN INCOMPATIBILITY OF THE RECIPIENT
WITH THE DONOR AS TO ANTIGENS OF
THE AVO SYSTEM BEFORE
ALLOGRAFTING OF BONE MARROW
The presence of incompatibility between donor and recipient as to antigens of the AVO system does not constitute a contraindication for performing allogenic According to international classification, there are 2 types of incompatibility as to antigens of the AVO system. By big incompatibility is meant the presence in the recipient’s blood of natural antibodies to erythrocytary antigens of the donor, arising in such situation the risk of hemolytic complications. For avoiding such sort of complications, it is necessary to remove a maximal quantity of erythrocytes of the donor from the transplantat and to perform exchange plasmapheresis in the recipient in order to remove antibodies. As small incompatibility as to antigens of the AVO system is identified the presence in the donor’s blood of isohemagglutinins to erythrocytary antigens of the recipient, resulting in such cases enough to remove the plasma from the transplantat. For more information visit our web site: www.plasmatech-fzc.com or contact us by e-mail: [email protected] PLASMAPHERESIS IN HEMATOLOGY
PLASMAPHERESIS
INDICATIONS
CRITERIA OF EFFICIENCY
AND LEUCOCYTAPHERESIS IN THE
TREATMENT OF HYPERLEUCOCYTOSIS
Indications for performing leucocytapheresis in patients with
acute myeloblastic leucosis
When the quantity of leucocytes in the patient’s blood is above 100 x 109/l, Hyperleucocytosis is an urgent condition in hematological patients, associated with severe vitally- On the background of the therapy with hydroxyurea, when the content of dangerous complications and so requiring emergency, leucocytes in the blood is over 100 x 109/l When presenting clinical signs of leucostasis In case of a very quick progression of the disease: duplication of the number By hyperleucocytosis is meant an increase of the level of leucocytes in peripheral blood over 30 x 109/l. Inefficiency of the treatment with hydroxyurea during 1 day, that is, drop of An increase of the amount of leucocytes above 100 x the level of leucocytes by less than 30% from the initial level 109/l (in cases of acute leucosis) is considered Indications for performing LCA in patients with chronic
myeloleucosis:
Under hyperleucocytosis, in the vessels of the Pronounced intoxication on the background of hyperleucocytosis of over 50- 100 x 109/l and hyperthrombocytosis of above 350 x 109/l, which bring cerebrum, kidneys and heart are formed clumps of leucoaggregates and thrombs from leucosis cells. Developed resistance to polychemotherapy (with progressing stage and blastic crisis), when the procedure is applied in order to remove a big tumoral mass, thus allowing to intensify the proliferative activity of the bone marrow and increase the efficiency of further courses of PChT Indications for performing LCA in patients with ChLL:
hyperuricemic syndrome, which bring about renal failure. As a consequence of a high level of proliferation Hyperleucocytosis of over 150-200 x 109/l, matching with anemia, thrombocytopenia, splenomegaly and inefficacy of the different schedules of of tumoral cells, metabolism and cellular breakdown, severe metabolic disorders may develop, including LCA is performed in blood separators under the LCA program, with a course hyperkaliemia, hypocalciemia and hyperphosphatemia. of up to 2-3 procedures and an interval of 7-10 days. Administration of heparin and protein blood substitutes is to be realized according to For more information visit our web site: www.plasmatech-fzc.com or contact us by e-mail: [email protected]

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