Therapeutic apheresis within immune-mediated neurological disorders: dosing and its effectiveness

被引:14
作者
Klingele, Matthias [1 ,4 ]
Allmendinger, Carina [1 ]
Thieme, Solmaz [2 ,3 ]
Baerens, Lea [1 ]
Fliser, Danilo [1 ]
Jan, Buermann [2 ,3 ]
机构
[1] Saarland Univ, Med Ctr, Homburg, Germany
[2] Dept Internal Med Nephrol & Hypertens, Homburg, Germany
[3] Dept Neurol, Homburg, Germany
[4] Hochtaunus Kliniken, Dept Nephrol, Bad Homburg, Germany
关键词
PLASMA-EXCHANGE; MULTIPLE-SCLEROSIS; MYASTHENIA-GRAVIS; IMMUNOADSORPTION; PLASMAPHERESIS; EXPERIENCE; REGISTRY; REMOVAL; NUMBER; SCALE;
D O I
10.1038/s41598-020-64744-4
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Plasma exchange (PE) and immunoadsorption (IA) are standard therapeutic options of immune-mediated neurological disorders. This study evaluates the relation of the relative quantity of applied dose of PE and/ or IA and its achieved therapeutic effectiveness within the treated underlying neurological disorders. In a retrospective study, we evaluated data from PE and IA carried out 09/2009-06/2014 in neurological patients at the University-Hospital of Saarland, Germany. Apheresis dose was defined as the ratio of the extracorporeal treated plasma volume to the patient's plasma volume. Effectiveness was assessed through disease-specific tests and scores by the attending neurologist(s); results were classified into response or no response. 1101 apheresis (PE:238, IA:863), in 153 hospital-stays were carried out, averaged, 7.0 treatments per patients, 82% responded, 18% not. Mean applied apheresis dose per treatment was 0.91 with mean doses of 1.16 for PE and 0.81 for IA. The totally applied mean dose per stay was 5.6 (PE:5.01, IA:5.81). No correlation was seen between apheresis dosing and treatment effectiveness (PE:R2 = 0.074, IA:R2 = 0.0023). PE and IA in therapy-refractory immune-mediated neurological disorders majorly achieved a measurable severity improvement without correlation to the applied dose. Moreover, our data rather suggest, that effectiveness may be given with volumes below currently recommended volumes.
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页数:7
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