TROMBOSiTOZ 

Tanım: Trombositoz; trombosit sayısının 450.000/mm3‘ün üzerinde olmasıdır. Myeloproliferatif hastalıkların hemen hepsinde trombositoz görülebilmekle birlikte en sık görülen hastalık esansiyel trombositozdur. Tromboz riski ile trombosit sayısı arasında net bir ilişki olmamakla birlikte, trombosit sayısı 1.500.000/mm3‘un üzerine çıktığında daha çok kanama riski artmaktadır. 

Gerekçe: Myeloproliferatif hastalıklarda kanama ve tromboz varlığında, ciddi kontrol edilemeyen trombositozlarda kullanılabilir. 

İşlem: Trombositaferez 

Sıklığı: Günlük 

İşlenen Volüm: 1,5-2 TKH 

Replasman Sıvısı: SF 

Uygulama sayı ve/veya süresi: Akut tromboemboli ve kanama durumunda hedef trombosit sayısının sitoreduktif tedavi etkisini gösterene kadar normal düzeylerde tutulmasıdır. Bilinen başka bir klinik öykü yoksa 600.000/mm3‘ün altına indirmek yeterlidir. 

YARARLANILAN LİTERATÜRLER

*Adami R. Therapeutic thrombocytapheresis: a review of 132 patients. Int J Artif Organs 1993;16 (Suppl 5):183–184. 

*Baron BW, Mick R, Baron JM. Combined plateletpheresis and cytotoxic chemotherapy for symptomatic thrombocytosis in myeloproliferative disorders. Cancer 1993;72:1209–1218. 

*Greist A. The role of blood component removal in essential and reactive thrombocytosis. Ther Apher 2002;6:36–44. 

*Schafer AI. Thrombocytosis. N Engl J Med 2004;350:1211–1219. 

*van Genderen PJ, Prins FJ, Lucas IS, van de Moesdijk D, van Vliet HH, van Strik R, Michiels JJ. Decreased half-life time of plasma von Willebrand factor collagen binding activity in essential thrombocythaemia: normalization after cytoreduction of the increased platelet count. Br J Haematol 1997;99:832–836. 

*Elliott MA, Tefferi A. Thrombosis and haemorrhage in polycythaemia vera and essential thrombocythaemia. Br J Haematol 2005;128:275–290.

*Edlich RF, Long WB, III, Cochran AA, Kelley AR, Woode DR, Greene JA, Takahashi GW. Management of femoral fracture in a patient with essential thrombocythemia treated with plateletpheresis and intramedullary rod fixation, followed by hydroxyurea: a case report. Am J Emerg Med 2008;26:636 e631–e633. 

*Yavasoglu I, Kadikoylu G, Bolaman Z. Recovery of splenic infarction with anti-platelet treatments and platelet-apheresis in polycythemia vera. Transfus Apher Sci 2006;34:199–202. 

*Yamaguchi K, Hisano M, Sakata M, Minatogawa Y, Suzuki T, Ozawa N, Kitagawa M, Murashima A. Periodic plateletpheresis during pregnancy in a high-risk patient with essential thrombocythemia. J Clin Apher 2006;21:256–259. 

*Nurkalem Z, Uslu N, Gorgulu S, Eren M. Left main coronary thrombosis with essential thrombocythemia. J Thromb Thrombolysis 2006;22:165–167. 

*Mesa RA, Nagorney DS, Schwager S, Allred J, Tefferi A. Palliative goals, patient selection, and perioperative platelet management: outcomes and lessons from 3 decades of splenectomy for myelofibrosis with myeloid metaplasia at the Mayo Clinic. Cancer 2006;107:361–370. 

*Koh LP, Devendra K, Tien SL. Four pregnancies in two patients with essential thrombocythaemia—a case report. Ann Acad Med Singapore 2002;31:353–356. 

*Wright CA, Tefferi A. A single institutional experience with 43 pregnancies in essential thrombocythemia. Eur J Haematol 2001;66:152–159. 

*Orlin JB, Berkman EM. Improvement of platelet function following plateletpheresis in patients with myeloproliferative diseases. Transfusion 1980;20:540–545. 

*Beard ME, Blacklock HA, Varcoe AR. Control of thrombocytosis by plateletpheresis using a cell separator. N Z Med J 1980;91:136–138. 

*Taft EG, Babcock RB, Scharfman WB, Tartaglia AP. Plateletpheresis in the management of thrombocytosis. Blood 1977;50:927–933.