Berrin BALIK, Vehbi DEMİRCAN, Abdullah KARAKUŞ, Bahattin GÖKDEMİR, Orhan AYYILDIZ
Cam and Sakura Medical Journal - 2026;6(2):59-66
Objective: This study aimed to evaluate the clinical spectrum, treatment characteristics, and outcomes of therapeutic apheresis (TA) procedures performed at a tertiary care university hospital, with particular emphasis on thrombotic thrombocytopenic purpura (TTP). Material and Methods: In this retrospective cohort study, 303 patients who underwent 2,289 apheresis procedures between 2010 and 2015 were evaluated. Patients were categorized according to the primary procedure performed: therapeutic plasma exchange [(TPE); n=110], therapeutic cytapheresis (n=85), and peripheral blood stem cell collection [(PBSC); n=59]. The remaining 49 patients underwent other apheresis procedures. PBSC cases were excluded from treatment-response analyses. TTP was diagnosed clinically on the basis of thrombocytopenia and microangiopathic haemolytic anaemia, with or without organ involvement, after exclusion of other thrombotic microangiopathies; ADAMTS13 activity testing was not routinely available during the study period. Results: Haematological diseases were the most common indication for apheresis (n=190, 62.7%). TPE was performed in 110 patients, including 22 (20.0%) with TTP. Among 244 patients eligible for outcome analysis, response status could be clearly classified for 218 patients: 144 (59.0%) had a complete response, 17 (7.0%) had a partial response, and 57 (23.4%) had no response. The mean number of apheresis sessions per patient was 7.5+/-3.9. In the TTP subgroup, 17 of 22 patients (77.2%) achieved a clinical response; 7 (31.8%) relapsed during follow-up, and 4 (18.2%) died from refractory disease or underlying critical illness. Procedure-related complications were infrequent; 209 patients (69.0%) had no complications. No deaths were directly attributed to the apheresis procedure. Conclusion: TA was widely used across multiple disciplines and showed an acceptable safety profile in our centre. Haematological disorders, particularly TTP and acute leukaemia, constituted the largest indication group. These findings support the continued role of TPE in routine clinical practice and emergency settings, while highlighting the need for contemporary prospective studies that incorporate ADAMTS13-guided evaluation and assess newer agents such as caplacizumab.
