Zehra Narlı ÖZDEMİR, Uğur ŞAHİN, Sinem Civriz BOZDAĞ, Meltem Kurt YÜKSEL, Selami Koçak TOPRAK, Pervin TOPÇUOĞLU, Muhit ÖZCAN, Önder ARSLAN, Taner DEMİRER, Meral BEKSAÇ, Günhan GÜRMAN, Osman İLHAN

Trombositozlu Olgularda Terapötik Trombosit Aferezinin Etkinliği

Amaç: Trombosit azaltılması olarak da bilinen terapötik trombosit aferezi (TTA), semptomatik hastalarda veya aşırı trombositozlu yüksek riskli hastaların profilaksisinde hızlı sitoredüksiyon için kullanılabilir. Bu yazıda, merkezimizin yaklaşık 20 yıllık TTA deneyimini sunuyoruz. Gereç ve Yöntem: Ocak 1999 - Aralık 2020 tarihleri arasında yapılan TTA işlemleri için Ankara Üniversitesi Tıp Fakültesi Terapötik Aferez Ünitesi tıbbi kayıtları retrospektif olarak incelendi. Bulgular: Kırk altı (%51,1) erkek, 44 (%48,9) kadın olmak üzere 90 hastaya toplam 196 TTA işlemi yapıldı. Ortanca yaş 52,5 yıl (18-83 yıl) olarak saptandı. Yetmiş dört (%82,2) hasta esansiyel trombositoz (ET), 5 (%5,6) hasta kronik miyeloid lösemi (KML), 5 (%5,6) hasta primer miyelofibrozis (PMF), 3 (%3,3) hasta akut fazda yaygın tromboz ve 3 (%3,3) hasta diğer tanılarla işleme alındı. Altmış bir (%67,8) hastanın başlangıç trombosit sayısı 1 TTA işlemine ihtiyaç duydu. TTA ile trombosit sayısı ortanca 571,5x109/L (72-3.128x109/L) ve %47,5 (%6,2-%92,4) azaltıldı. TTA prosedürleri sonucunda 19 (%21,1) hastada ≤450x109/L, 56 (%62,2) hastada 450-1.000x109/L, 15 (%16,7) hastada ≥1.000x109/L PLT sayısı elde edildi. Hastalar başlangıç trombosit sayılarına göre PLT

The Efficacy of Therapeutic Thrombocytapheresis in Patients with Thrombocytosis

Objectives: 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. Materials and Methods: The medical registry of Ankara University Faculty of Medicine Therapeutic Apheresis Unit was retrospectively reviewed for TTA procedures between January 1999 and December 2020. Results: 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 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]. Conclusion: 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.

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