Therapeutic Apheresis in Pediatrics with Neurological and Hematological Diseases

Abstract

Rolf Bambauer and Ralf Schiel

The advantages of therapeutic apheresis (TA) with hollow fiber membranes are a complete separation of the corpuscular components from the plasma and due to increased blood flow rate higher efficacy [1]. The use of therapeutic apheresis in pediatric patients, which increasing more and more, has always been restricted by technical difficulties and the low incidence of diseases requiring this kind of treatment. The development of new, more sophisticated membranes and new adsorption technologies allow the most selective separation of plasma components. TA has been successfully introduced in a variety of autoantibody-mediated diseases [2]. The updated information on immunology and molecular biology of different neurological and hematological diseases are discussed in relation to the rationale for apheresis therapy and its place in combination with other modern treatments. The different diseases can be treated by various apheresis methods. Pathogenetical aspects are demonstrated in these diseases, in which they are clarified. TA has been shown to effectively remove the autoantibodies from blood and lead to rapid clinical improvement. For the neurological and hematological diseases, which can be treated with TA, the guidelines of the Apheresis Application Committee (AAC) of the American Society for Apheresis (ASFA) are cited [3, 4].

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