Apheresis therapies play an important role in the treatment of many pathologies, both as first-line and rescue therapies after drug failure or drug toxicity and, furthermore, when it is important to reach a therapeutic goal in a short time.
Apheresis devices have evolved at an astounding rate over the last decades.
Therapeutic apheresis are usually part of a treatment plan, so, a patient-centered approach to select the most appropriate treatment for each patient, balancing personal preferences, medication interferences and technological availability can significantly influence the choice of the protocol to be used. But, if the wide diversity of apheresis treatments may offer a tailored-patient approach, it can also create concerns on the right decision about the most appropriate protocol.
Therapeutic apheresis – whose purpose is to cure diseases due to abnormality of blood cells or to toxicity of plasma substances – and, productive apheresis – whose purpose is to produce autologous or allogeneic therapeutic hemocomponents – are widely known as plasma-treatments and cytapheresis.
The elementary techniques in apheresis are well represented by three physical separation methods of blood components:
- differential centrifugation
- membrane filtration
- adsorption of proteins or cells, from whole blood or from plasma already separated.
Starting from these three processes, several apheretic techniques have been developed to ensure, in expert hands, excellent therapeutic efficacy together with a low profile of adverse events.
KEY WORDS: Apheresis, techniques, plasma-treatment, cytapheresis, blood-cell separators.