UNLABELLED: Therapeutic apheresis (TA) is prescribed to patients that suffer from a severe progressive disease that is not sufficiently treated by conventional medications. A way to gain more knowledge about this treatment is usually by the local analysis of data. However, the use of large quality assessment registries enables analyses of even rare findings. Here, we report some of the recent data from the World Apheresis Association (WAA) registry. Data from >104,000 procedures were documented, and TA was performed on >15,000 patients. The main indication for TA was the collection of autologous stem cells (45% of patients) as part of therapy for therapy. Collection of stem cells from donors for allogeneic transplantation was performed in 11% of patients. Patients with indications such as neurological diseases underwent plasma exchange (28%). Extracorporeal photochemotherapy, lipid apheresis, and antibody removal were other indications. Side effects recorded in the registry have decreased significantly over the years, with approximately only 10/10,000 procedures being interrupted for medical reasons. CONCLUSION: Collection of data from TA procedures within a multinational and multicenter concept facilitates the improvement of treatment by enabling the analysis of and feedback on indications, procedures, effects, and side effects.

Apheresis Center North Rostock Germany

Apheresis Center University Hospital Lund Sweden

Apheresis Center University Hospital Orebro Sweden

Apheresis Unit Coimbra University Hospital Coimbra Portugal

Apheresis Unit Haematological AKH Vienna Austria

Apheresis Unit Renal AKH Vienna Austria

Apheresis Unit University Hospital Ostrava Czechia

Banc de Sang i Teixits Hospital Bellvitge Barcelona Spain

Blood Center Livorno Italy

Blood Center University Uppsala Sweden Uppsala Sweden

Bone Marrow Transplant and Apheresis Concord New South Wales Australia

Center for Immunology and Transfusion Akers University Hospital Loerenskog Norway

Clinical Immunology and Transfusion Medicine Linköping University Linköping Sweden

Department Haematology University Hospital Ankara Turkey

Department of Hematology AZ Delta Roeselare Belgium

Department of Nephrology Karlstad Sweden

Department of Nephrology Skaraborg Hospital Skövde Sweden

Department of Nephrology University Hospital Ghent Belgium

Department of Nephrology University Hospital Huddinge Sweden

Department of Nephrology University Hospital Skopje North Macedonia

Department of Nephrology University Hospital Uppsala Sweden

Hemapheretic Center of the 3rd Department of Medicine Medical Faculty and University Hospital Hradec Kralove Czechia

Institute for Endocrinology University Hospital Belgrade Serbia

Institute of Hematology and Blood Transfusion Prague Czechia

Italian National Blood Centre National Institute of Health Rome Italy

Nephrology Rheumatology Blood Purification Academic Teaching Hospital Braunschweig Germany

Public Health and Clinical Medicine Umeå University Umeå Sweden

Sanquin Blood Supply Amsterdam The Netherlands

South African National Blood Service Johannesburg South Africa

St Anna Pediatric Department Vienna Austria

Therapeutic Apheresis Unit University Hospital Vilnius Lithuania

Transfusion Medicine and Transplantation Biology University Zagreb Croatia

Transfusion Medicine Frydek Mistek Czechia

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Schwartz J, Padmanabhan A, Aqui N, Balogun RA, Connelly-Smith L, Delaney M, et al. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Seventh Special Issue. J Clin Apher. 2016 Jun;31((3)):149–62. PubMed

De Silvestro G. The Italian registry of therapeutic apheresis − 2015. Transfus Apheresis Sci. 2017 Feb;56((1)):75–81. PubMed

De Silvestro G, Tison T. Italian Society of A, Cell M. Italian Registry of Therapeutic Apheresis. Transfusion and apheresis science: official journal of the World Apheresis Association: official journal of the European Society for Haemapheresis. 2018;57((2)):143–147. PubMed

Mörtzell Henriksson M, Newman E, Witt V, Derfler K, Leitner G, Eloot S, et al. Adverse events in apheresis: an update of the WAA registry data. Transfus Apheresis Sci. 2016 Feb;54((1)):2–15. PubMed

Stegmayr B, Mortzell Henriksson M, Newman E, Witt V, Derfler K, Leitner G, et al. Distribution of indications and procedures within the framework of centers participating in the WAA apheresis registry. Transfusion and apheresis science: official journal of the World Apheresis Association: official journal of the European Society for Haemapheresis. 2017 PubMed

Padmanabhan A, Connelly-Smith L, Aqui N, Balogun RA, Klingel R, Meyer E, et al. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Eighth Special Issue. J Clin Apher. 2019 Jun;34((3)):171–354. PubMed

Stegmayr BG, Ivanovich P, Korach JM, Rock G, Norda R, Ramlow W. World apheresis registry. J Clin Apher. 2005 Jul;20((2)):126–7. PubMed

Stegmayr BG, Ivanovich P, Korach JM, Rock G, Norda R, Ramlow W. World apheresis association—world apheresis registry. Transfus Apheresis Sci. 2005 Apr;32((2)):205–7. PubMed

Stegmayr B, Korach JM, Norda R, Rock G, Fadel F. Is there a need for a national or a global apheresis registry? Transfusion and apheresis science: official journal of the World Apheresis Association: official journal of the European Society for Haemapheresis. 2003;29((2)):179–85. PubMed

Stegmayr B. The World Apheresis Association Registry. Transfusion and apheresis science: official journal of the World Apheresis Association: official journal of the European Society for Haemapheresis. 2017 PubMed

Stegmayr B, Ptak J, Wikstrom B. World apheresis registry report. Transfusion and apheresis science: official journal of the World Apheresis Association: official journal of the European Society for Haemapheresis. 2007;36((1)):13–6. PubMed

Stegmayr B, Ptak J, Wikström B, Berlin G, Axelsson CG, Griskevicius A, et al. World apheresis registry 2003-2007 data. Transfus Apheresis Sci. 2008 Dec;39((3)):247–54. PubMed

Witt V, Stegmayr B, Ptak J, Wikström B, Berlin G, Axelsson CG, et al. World apheresis registry data from 2003 to 2007, the pediatric and adolescent side of the registry. Transfus Apheresis Sci. 2008 Dec;39((3)):255–60. PubMed

Bláha M, Pták J, Cáp J, Ceeová V, Masín V, Filip S, et al. WAA apheresis registry in the Czech Republic: two centers experience. Transfus Apheresis Sci. 2009 Aug;41((1)):27–31. PubMed

Blaha M, Ptak J, Cap J, Ceeova V, Masin V, Filip S, et al. WAA apheresis registry in the Czech Republic: two centers experience. Transfusion and apheresis science: official journal of the World Apheresis Association: official journal of the European Society for Haemapheresis. 2009;41((1)):27–31. PubMed

Mortzell M, Berlin G, Nilsson T, Axelsson CG, Efvergren M, Audzijoni J, et al. Analyses of data of patients with Thrombotic Microangiopathy in the WAA registry. Transfusion and apheresis science: official journal of the World Apheresis Association: official journal of the European Society for Haemapheresis. 2011;45((2)):125–31. PubMed

Stegmayr B, Ptak J, Nilsson T, Berlin G, Mirea V, Axelsson CG, et al. Panorama of adverse events during cytapheresis. Transfusion and apheresis science: official journal of the World Apheresis Association: official journal of the European Society for Haemapheresis. 2013;48((2)):155–6. PubMed

Norda R, Axelsson CG, Axdorph U, Berlin G, Wikström B, Stegmayr B, Swedish Apheresis Group Recognition of intercenter differences may help develop best practice. Ther Apher Dial. 2008 Oct;12((5)):347–54. PubMed

Bing-Lei W, Jia-Hua Z, Yan L, Zan Y, Xin B, Jian-Hua S, et al. Three cases of antibody-LGI1 limbic encephalitis and review of literature. Int J Neurosci. 2019 Jul;129((7)):642–8. PubMed

Esposito S, Principi N, Calabresi P, Rigante D. An evolving redefinition of autoimmune encephalitis. Autoimmun Rev. 2019 Feb;18((2)):155–63. PubMed

Jones RB, Hiemstra TF, Ballarin J, Blockmans DE, Brogan P, Bruchfeld A, et al. European Vasculitis Study Group (EUVAS) Mycophenolate mofetil versus cyclophosphamide for remission induction in ANCA-associated vasculitis: a randomised, non-inferiority trial. Ann Rheum Dis. 2019 Mar;78((3)):399–405. PubMed

McAdoo SP, Medjeral-Thomas N, Gopaluni S, Tanna A, Mansfield N, Galliford J, et al. Long-term follow-up of a combined rituximab and cyclophosphamide regimen in renal anti-neutrophil cytoplasm antibody-associated vasculitis. Nephrol Dial Transplant. 2019 Jan;34((1)):63–73. PubMed PMC

Patterson K, Iglesias E, Nasrallah M, González-Álvarez V, Suñol M, Anton J, et al. Anti-MOG encephalitis mimicking small vessel CNS vasculitis. Neurol Neuroimmunol Neuroinflamm. 2019 Feb;6((2)):e538. PubMed PMC

Pepper RJ, McAdoo SP, Moran SM, Kelly D, Scott J, Hamour S, et al. A novel glucocorticoid-free maintenance regimen for anti-neutrophil cytoplasm antibody-associated vasculitis. Rheumatology (Oxford) 2019 Feb;58((2)):260–8. PubMed

Si Z, Wang A, Liu J, Zhang Z, Hu K. Typical clinical and imaging manifestations of encephalitis with anti-γ-aminobutyric acid B receptor antibodies: clinical experience and a literature review. Neurol Sci. 2019 Apr;40((4)):769–77. PubMed

Strunk D, Schmidt-Pogoda A, Beuker C, Milles LS, Korsukewitz C, Meuth SG, et al. Biomarkers in Vasculitides of the Nervous System. Front Neurol. 2019 Jun;10:591. PubMed PMC

Stuhlmüller B, Schneider U, González-González JB, Feist E. Disease Specific Autoantibodies in Idiopathic Inflammatory Myopathies. Front Neurol. 2019 May;10:438. PubMed PMC

Norda R, Berséus O, Stegmayr B. Adverse events and problems in therapeutic hemapheresis. A report from the Swedish registry. Transfus Apheresis Sci. 2001 Aug;25((1)):33–41. PubMed

Norda R, Knutson F, Berseus O, Akerblom O, Nilsson-Ekdahl K, Stegmayr B, et al. Unexpected effects of donor gender on the storage of liquid plasma. Vox Sang. 2007 Oct;93((3)):223–8. PubMed

Norda R, Schött U, Berséus O, Akerblom O, Nilsson B, Ekdahl KN, et al. Complement activation products in liquid stored plasma and C3a kinetics after transfusion of autologous plasma. Vox Sang. 2012 Feb;102((2)):125–33. PubMed

Norda R, Stegmayr BG, Swedish Apheresis Group Therapeutic apheresis in Sweden: update of epidemiology and adverse events. Transfus Apheresis Sci. 2003 Oct;29((2)):159–66. PubMed

Norda R, Stegmayr BG, Swedish Apheresis Study Group Apheresis registry in Sweden: scope, techniques and indications for treatment. A report from the Swedish apheresis study group. Transfus Apheresis Sci. 2001 Feb;24((1)):49–55. PubMed

Stegmayr B, Tärnvik A. Complement activation in plasma exchange by single filtration and centrifugation and in cascade filtration. Blood Purif. 1989;7((1)):10–5. PubMed

Toss F, Edgren G, Berlin G, Stegmayr B, Witt V. Does prophylactic calcium in apheresis cause more harm than good? - Centre heterogeneity within the World Apheresis Association Register prevents firm conclusions. Vox Sang. 2018 Oct;113((7)):632–8. PubMed