Effects of high-volume platelet-lowering therapy on patients' coagulation indices using a continuous-flow cell separator

Abstract:

Objective：To explore the effects of high-volume platelet-lowering therapy on the comprehensive coagulation indices and fibrinogen concentration of patients with thrombocytosis using a continuous-flow cell separator（CFCS）. Methods：Patients with throm－bocytosis underwent a platelet-lowering therapy administered by the ELP/MNC program of a COBE Spectra CFCS using ACD-A as an anticoagulant. A total of 32 platelet-lowering treatments were performed for 21 patients with the treated blood volume for each treatment set as 2.5 to 3.0 times the total blood volume（TBV） and the collected platelet suspension volume as 20% to 25% of TBV. The effect of platelet-lowering therapy and the changes in coagulation indices and fibrinogen concentration after treatment were eval－uated. Results：A single treatment had a run time of （212.53±41.54） minutes with a treated blood volume of （8 812.63±2 087.15） mL and a collected platelet suspension volume of （798.84±190.77） mL. The patients’ coagulation indices in circulating blood before and after treatment were as follows：platelet count：（1426.46±530.23）×109 cells/L vs. （778.83±247.25）×109 cells/L（t=10.808，P=0.000），prothrombin time（PT）：（12.82±1.53） s vs. （13.28±1.51） s（t=3.921，P=0.000），activated partial thromboplastin time（aPTT）：35.75 （29.43，37.55） s vs. 35.40（31.20，38.20） s（Z=3.021，P=0.003），thrombin time（TT）：（17.46±1.30） s vs. （17.88±1.41） s（t=2.783，P=0.009），fibrinogen concentration（Fbg）：（2.96±1.18） g/L vs. （2.81±1.11） g/L（t=3.433，P=0.002）. Conclusion：High-volume platelet-lowering therapy using a CFCS can significantly reduce the platelet load within the body of patients with thrombocytosis，and its effects on PT，aPTT，TT，and Fbg are within the normal range of body compensation.