Terapeutické hemaferézy

Therapeutic Haemaphereses

Therapeutic haemaphereses are therapeutic procedures the objective of which is to reduce the contentsof a pathogenic substance or cellular elements in the patient’s circulation whereby the removedconstituents are replaced by solutions of crystalloids, colloids, plasma or cellular elements froma healthy donor. The therapeutic techniques are divided into groups of depletion methods which arerepresented by leukaphereses, lymphocytaphereses, erythrocytaphereses and thrombocyte depletion.As to exchange procedures, the authors were concerned with the problem of exchange plasmapheresisand exchange erythrocytapheresis. They present also experience with the preparation of a lymphocyteconcentrate (DLI) to induce the graft-versus leukaemia effect (GVL), the method of extracorporealphotochemotherapy (ECP), the problem of paediatric haemaphereses and separations of haemopoieticprogenitor cells from the peripheral blood stream (PBPC) which were implemented by a standard andlarge volume (LVL) regime. LVL preparations made it possible to prepare a larger number of CD34+cells as compared with standard operations. Higher amounts of progenitor cells were obtained frompatients with a good effect of mobilization as well as in inadequately mobilized patients. In patientswith a good effect of mobilization one LVL separation was sufficient to prepare a CD34+ dose of cellsof more than 5x10 6 /kg. LVL procedures can be recommended under all circumstances when the patientor donor can tolerate them. A particularly important part is played by these procedures in patientswith an inadequate effect of mobilization where they are the only possibility how to prepare at leasta minimal amount of progenitor cells for transplantation and for influencing the course of the basicdisease.

Key words:
blood, apheresis, therapeutical methodsblood, apheresis, therapeutical methods