High-dose plasma infusion versus plasma exchange as early treatment of @entity2106 / XXXX .

@entity1 @entity644 @entity1212 @entity11849 @entity16715 @entity1891 @entity1381 @entity1985 @entity715 @entity2106 @entity1284
@entity2106 and adult @entity1381 ( @entity2106 / @entity11849 ) have a substantial mortality rate even with currently available treatments. Although therapeutic plasma exchange is the recommended treatment of @entity2106 / @entity11849 , this cumbersome procedure may not be available for all @entity1 in an emergency. In this context, plasma infusion may represent an alternative first-line therapy. We compared the effectiveness of high-dose plasma infusion (25-30 mL/kg per day) and therapeutic plasma exchange as first-line treatment of adult @entity2106 / @entity11849 at a single center. Two groups of @entity1 with @entity2106 / @entity11849 were identified according to their initial therapy, that is, high-dose plasma infusion (19 @entity1 ) and therapeutic plasma exchange (18 @entity1 ). Clinical charts and outcomes were retrospectively analyzed. Endpoints for comparison were the duration of platelet counts below 150 x 10 /L and LDH levels above normal values; the volumes of plasma administered and the duration of treatment; complete remission, relapse, and mortality rates; and treatment-related complications. @entity1 of the 2 groups had comparable clinical and laboratory features on admission. Sixteen @entity1 achieved complete remission in each group. Median times to recovery of platelet counts and LDH levels were comparable between the 2 groups. Eight @entity1 in the high-dose plasma infusion (HD-PI) group were switched to therapeutic plasma exchange because of @entity1284 (6 @entity1 ), persistent biologic disturbances (1 @entity1 ), or @entity16715 to high-dose plasma infusion treatment (1 @entity1 ). This latter @entity1 had severe @entity2106 / @entity11849 that remained refractory to therapeutic plasma exchange and @entity1891 , and rapidly died. All 7 remaining @entity1 achieved complete remission with therapeutic plasma exchange. Four @entity1 in the HD-PI group and 3 @entity1 in the therapeutic plasma exchange (TPE) group died. In the HD-PI group, 5 @entity1 experienced a transient @entity1985 -range @entity644 during treatment. Main complications in the TPE group were collapse (1 @entity1 ) and central @entity1212 (2 @entity1 ) or @entity715 (1 @entity1 ). Three @entity1 in each group relapsed. High-dose plasma infusion may be an efficient treatment of @entity2106 / @entity11849 in @entity1 who cannot have early plasma exchange. However, the large volumes of plasma required to reach complete remission may result in @entity1284 , which may necessitate subsequent therapeutic plasma exchange.
