The results of Therapeutic Apheresis treatment on patients with hematological diseases who received treatment at Krabi Hospital during the period of 2016 to 2023

Abstract

Therapeutic Apheresis is a treatment for patients by separating components in the blood, such as white blood cells, lymph, and substances in the lymph that cause disease, from the patient. Apheresis in the long term will help chronic patients reduce the dosage of immunosuppressive drugs. resistance, such as steroids Reduce the duration of inpatient treatment as well as resulting in patients living and working normally. This research design was Retrospective descriptive study aimed at studying the results of Therapeutic Apheresis treatment on patients with hematological diseases who received treatment at Krabi Hospital. The objectives were to examine the efficacy of treating patients by separating blood components and to study the side effects of this treatment method. The research period is December 2023 to March 2024. A specific random sample was drawn from patients diagnosed with TTP and AIHA disease. There were 9 cases treated as inpatients and received treatment using Therapeutic apheresis. Data were collected using patient records from medical records and analyzed using descriptive statistics, presenting numbers, percentages, means, and ranges.

The results found that Sample groups that received treatment with the method Therapeutic Plasma Exchange (TPE) 9 cases. 8 cases (88.89%) survived and were discharged, while 1 case (11.11%) passed away. Among the surviving patients, 1 case (11.11%) had TPE discontinued. Laboratory test results showed a decrease in lactate dehydrogenase (LDH) levels from an average of 1,688 U/L before TPE to 919 U/L after TPE, an increase in hematocrit (Hct) from an average of 20% before TPE to 21% after TPE, and an increase in platelet count from an average of 50,556 cell/mm³ before TPE to 95,778 cell/mm³ after TPE. Minor adverse effects were observed in 3 cases (33.33%) during TPE, including pruritus in       2 cases and tremors and pruritic rash in 1 case.

          In conclusion, Therapeutic Apheresis treatment for patients with hematological diseases, specifically Thrombotic Thrombocytopenic Purpura (TTP) and Autoimmune Hemolytic Anemia (AIHA), showed efficacy in treating TTP and AIHA. Therefore, Therapeutic Plasma Exchange doctors and related medical personnel should be considered as a first-line therapy for TTP patients and should also be considered for AIHA patients. Additionally, to reduce complications, administration of 10% calcium gluconate to prevent hypocalcemia and the use of male donor fresh frozen plasma (FFP) to mitigate other adverse effects should be considered