International Journal of Hematology and Oncology 2022, Vol 32, Num 4 Page(s): 202-208
Therapeutic Plasma Exchange in Neurological Disorders: A 9-year Experience

Merih Reis ARAS1, Mehlika PANPALLI ATES2, Murat ALBAYRAK1, Hacer Berna AFACAN OZTURK1, Abdulkerim YILDIZ3, Fatma YILMAZ1, Bugra SAGLAM1, Selim Selcuk COMOGLU2

1University of Health Sciences Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, TURKIYE
2University of Health Sciences Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Department of Neurology, Ankara, TURKIYE
3Ministry of Health Hitit University Erol Olcok Training and Research Hospital, Department of Hematology, Corum, TURKIYE

Keywords: Therapeutic plasma exchange, Myastenia Gravis, Guillain Barre Syndrome, MRC score
Therapeutic plasma exchange (TPE), is based on the removal of pathogenic substrates from plasma with replacement fluid. Especially in refractory cases to standart treatment protocols, TPE procedures are performed for many neurological disorders. The aim of this study was to analyse the efficacy and safety of TPE in patients with neurological disorders. This retrospective study was conducted between 2012 and 2021 in our tertiary referral hospital, Adult Hematology Clinic and Therapeutic Apheresis Unit. The study included 59 patients with a total of 267 therapeutic procedures. The response to treatment was evaluated with the Medical Research Council (MRC) scoring system. The 59 patients comprised of 30 (50.8%) males and 29 (49.2%) females with a median age of 52 [20-80] years. Of these patients 44.1% were diagnosed with Myastenia Gravis (MG), 27.3% with Guillain Barre Syndrome (GBS), and 8.5% with Multiple Sclerosis (MS). The median number of TPE sessions per patient was 5 (1-7). The overall response rate was 76.3%. Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIPD), Transverse myelitis (TM), and MG have higher rates than other disease subtypes. The MRC score was significantly higher in the group with response than the group with no symptom regression (p= 0.001). The current study highlighted that TPE is a safe and effective treatment option with mild to moderate and manageable adverse events in patients with neurological disorders. Evaluation of response with the MRC scoring system was beneficial as a reliable quantative response.