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Diana JS, Manceau S, Rabeony T, Elie C, Jolaine V, Zamora S, Aubart M, Salvi N, Bodemer C, Bader-Meunier B, Barnerias C, Iserin F, Chardot C, Lacaille F, Renolleau S, Salomon R, Joseph L, Cavazzana M, Lefrere F, Dupic L, Delville M. Therapeutic plasma exchange for life-threatening pediatric disorders. J Clin Apher 2021; 36:823-830. [PMID: 34469617 DOI: 10.1002/jca.21934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Therapeutic plasma exchange (TPE) is acknowledged to be an effective treatment in life-threatening pediatric disorders. Apheresis for pediatric diseases has been poorly investigated, and most studies to date featured small numbers of patients and lacked control groups. The objective of the present study was to evaluate the tolerance of TPE in pediatric patients. MATERIALS AND METHODS A retrospective cohort study via a web-based electronic case report form including pediatric patients referred for TPE between January 2005 and December 2014. RESULTS A total of 78 patients (median [range] age: 9.8 [0.53-17.93]) and 731 TPE procedures were analyzed. The indications were antibody-mediated rejection (n = 33; 42%) and desensitization therapy (n = 5; 6%) after solid organ or hematopoietic stem cell transplantation, thrombotic microangiopathy (n = 17; 22%), pediatric inflammatory diseases (n = 16; 21%), kidney diseases (n = 6; 8%), and hyperviscosity syndrome (n = 1; 1%). On average, each patient underwent six procedures during the first session [range: 1-19]. In the 2 weeks following the start of a session, 72 patients (92%) presented a total of 311 adverse events (AEs) potentially related to TPE. The risk of AEs was not related to the indication for TPE, the intensity of care, venous access, plasma substitute use, or body weight. None of the deaths was related to the TPE. CONCLUSION We studied one of the largest retrospective pediatric cohorts described to date. Our experience of TPE children's TPE feasibility concerned specific, life-threatening conditions and otherwise treatment-refractory diseases.
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Affiliation(s)
- Jean-Sebastien Diana
- Hôpital Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France
| | - Sandra Manceau
- Hôpital Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France
| | | | - Caroline Elie
- Université de Paris, Paris, France.,Institut Imagine, Paris, France
| | - Valerie Jolaine
- Université de Paris, Paris, France.,Institut Imagine, Paris, France
| | | | | | | | - Christine Bodemer
- Hôpital Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France
| | | | | | | | - Christophe Chardot
- Hôpital Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France
| | | | - Sylvain Renolleau
- Hôpital Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France
| | - Remi Salomon
- Hôpital Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France
| | | | - Marina Cavazzana
- Hôpital Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France.,Institut Imagine, Paris, France
| | | | | | - Marianne Delville
- Hôpital Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France.,Institut Imagine, Paris, France
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Rice GI, Meyzer C, Bouazza N, Hully M, Boddaert N, Semeraro M, Zeef LAH, Rozenberg F, Bondet V, Duffy D, Llibre A, Baek J, Sambe MN, Henry E, Jolaine V, Barnerias C, Barth M, Belot A, Cances C, Debray FG, Doummar D, Frémond ML, Kitabayashi N, Lepelley A, Levrat V, Melki I, Meyer P, Nougues MC, Renaldo F, Rodero MP, Rodriguez D, Roubertie A, Seabra L, Uggenti C, Abdoul H, Treluyer JM, Desguerre I, Blanche S, Crow YJ. Reverse-Transcriptase Inhibitors in the Aicardi–Goutières Syndrome. N Engl J Med 2018; 379:2275-7. [PMID: 30566312 DOI: 10.1056/nejmc1810983] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | - Naïm Bouazza
- Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Marie Hully
- Hôpital Necker–Enfants Malades, Paris, France
| | | | | | - Leo A H Zeef
- University of Manchester, Manchester, United Kingdom
| | | | | | | | | | - Jinmi Baek
- Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Mame N Sambe
- Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Elodie Henry
- Assistance Publique–Hôpitaux de Paris, Paris, France
| | | | | | - Magalie Barth
- Centre Hospitalier Universitaire Angers, Angers, France
| | | | - Claude Cances
- Centre Hospitalier Universitaire Toulouse, Toulouse, France
| | | | | | | | | | | | | | | | | | | | | | | | | | - Agathe Roubertie
- Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | | | | | - Hendy Abdoul
- Assistance Publique–Hôpitaux de Paris, Paris, France
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