USE OF OCTAPLASLG IN THE TREATMENT OF THROMBOTIC MICROANGIOPATHIES (TMA)
(Abstract release date: 05/19/16)
EHA Library. Vendramin C. 06/09/16; 133127; E1578
Dr. Chiara Vendramin
Contributions
Contributions
Abstract
Abstract: E1578
Type: Eposter Presentation
Background
Thrombotic thrombocytopenic purpura (TTP) is a rare and acute disorder and plasma exchange (PEX) remains the life-saving therapeutic procedure in patients with TTP and other thrombotic microangiopathic anemias (TMA). OctaplasLG (Octapharma), a virally inactivated prion reducing plasma, has replaced the Solvent-Detergent Fresh-Frozen Plasma (Octaplas®; Octapharma) to improve the safety of plasma.
Aims
Aim of this study was to assess safety of OctaplasLG administration for patients undergoing PEX.
Methods
We performed a prospective study of 90 patients, treated with PEX for TMAs from a single institution over a 36 month period, January 1st 2013 – December 31st 2015. We recorded: virology on admission and in remission for all patients, allergic reactions to plasma, citrate toxicities associated with PEX, venous thrombotic events (VTE) rates and incidence of central venous access (CVA) line sepsis (which can result in exacerbation of TTP).
Results
Over the 36-month period, a total of 981 PEX procedures were performed (median 9, range 0-37). 62 patient episodes were TTP: 45 females (median age: 47 years; range: 15-89) and 17 males (median age: 49 years; range: 21-79); 51 patient episodes were De Novo presentations (43 idiopathic, 5 HIV, 1 Congenital and 2 Pancreatitis) and 11 were relapsed presentations. 17 patient episodes were HUS / aHUS, of which 12 females and 5 males. 11 patient episodes were ‘Other TMAs’ (8 females and 3 males). Citrate toxicity was 5.3% of PEX, (facial and limb tingling). Plasma reactions were 1.7% of PEX (hives and facial swelling) relieved by anti-histamines. No episodes of anaphylaxis and no TRALI were reported. Two cases of line associated sepsis were recorded and 11 cases of VTE were diagnosed (5 PE; day of PE (range): 5-35; platelets count (range): 35-228; 6 DVT; day of DVT (range): 6-43; platelets count (range): 86-264). Virology was checked for all patients. On admission for Hepatitis B they were subdivided into different groups: 57 patients had no evidence of infection or immunisation, 12 patients had evidence of previous immunisation and 9 patients had previous evidence of Hepatitis B infection. No viral transfer was documented following treatment. HCV Ab on admission: 89 negative, 1 positive. There was no antibody transfer post treatment. Pre PEX HIV: 5 positive, 85 negative. No seroconversion was detected post treatment.
Conclusion
Citrate toxicities are reduced in severity, likely due to shortened PEX with the Optya. Reactions with Octaplas remain minimal, with no severe anaphylaxis noted. VTE events, despite prophylactic LMWH starting when platelets are >50x109/L, occurred in 12% of cases, with 50% completed PEX when VTE was recorded. Adherence to our CVA line policy has resulted in a further reduction to our line related infections. In plasma high volume users, virology is important on admission to establish viral profile of the patients and in the follow-up for checking eventual infectious transmission. To date no viral transfer or antibody transfer or seroconversions were reported post treatment, likely due to safety of OctaplasLG.
Session topic: E-poster
Keyword(s): Thrombotic microangiopathy, Thrombotic thrombocytopenic purpura (TTP)
Type: Eposter Presentation
Background
Thrombotic thrombocytopenic purpura (TTP) is a rare and acute disorder and plasma exchange (PEX) remains the life-saving therapeutic procedure in patients with TTP and other thrombotic microangiopathic anemias (TMA). OctaplasLG (Octapharma), a virally inactivated prion reducing plasma, has replaced the Solvent-Detergent Fresh-Frozen Plasma (Octaplas®; Octapharma) to improve the safety of plasma.
Aims
Aim of this study was to assess safety of OctaplasLG administration for patients undergoing PEX.
Methods
We performed a prospective study of 90 patients, treated with PEX for TMAs from a single institution over a 36 month period, January 1st 2013 – December 31st 2015. We recorded: virology on admission and in remission for all patients, allergic reactions to plasma, citrate toxicities associated with PEX, venous thrombotic events (VTE) rates and incidence of central venous access (CVA) line sepsis (which can result in exacerbation of TTP).
Results
Over the 36-month period, a total of 981 PEX procedures were performed (median 9, range 0-37). 62 patient episodes were TTP: 45 females (median age: 47 years; range: 15-89) and 17 males (median age: 49 years; range: 21-79); 51 patient episodes were De Novo presentations (43 idiopathic, 5 HIV, 1 Congenital and 2 Pancreatitis) and 11 were relapsed presentations. 17 patient episodes were HUS / aHUS, of which 12 females and 5 males. 11 patient episodes were ‘Other TMAs’ (8 females and 3 males). Citrate toxicity was 5.3% of PEX, (facial and limb tingling). Plasma reactions were 1.7% of PEX (hives and facial swelling) relieved by anti-histamines. No episodes of anaphylaxis and no TRALI were reported. Two cases of line associated sepsis were recorded and 11 cases of VTE were diagnosed (5 PE; day of PE (range): 5-35; platelets count (range): 35-228; 6 DVT; day of DVT (range): 6-43; platelets count (range): 86-264). Virology was checked for all patients. On admission for Hepatitis B they were subdivided into different groups: 57 patients had no evidence of infection or immunisation, 12 patients had evidence of previous immunisation and 9 patients had previous evidence of Hepatitis B infection. No viral transfer was documented following treatment. HCV Ab on admission: 89 negative, 1 positive. There was no antibody transfer post treatment. Pre PEX HIV: 5 positive, 85 negative. No seroconversion was detected post treatment.
Conclusion
Citrate toxicities are reduced in severity, likely due to shortened PEX with the Optya. Reactions with Octaplas remain minimal, with no severe anaphylaxis noted. VTE events, despite prophylactic LMWH starting when platelets are >50x109/L, occurred in 12% of cases, with 50% completed PEX when VTE was recorded. Adherence to our CVA line policy has resulted in a further reduction to our line related infections. In plasma high volume users, virology is important on admission to establish viral profile of the patients and in the follow-up for checking eventual infectious transmission. To date no viral transfer or antibody transfer or seroconversions were reported post treatment, likely due to safety of OctaplasLG.
Session topic: E-poster
Keyword(s): Thrombotic microangiopathy, Thrombotic thrombocytopenic purpura (TTP)
Abstract: E1578
Type: Eposter Presentation
Background
Thrombotic thrombocytopenic purpura (TTP) is a rare and acute disorder and plasma exchange (PEX) remains the life-saving therapeutic procedure in patients with TTP and other thrombotic microangiopathic anemias (TMA). OctaplasLG (Octapharma), a virally inactivated prion reducing plasma, has replaced the Solvent-Detergent Fresh-Frozen Plasma (Octaplas®; Octapharma) to improve the safety of plasma.
Aims
Aim of this study was to assess safety of OctaplasLG administration for patients undergoing PEX.
Methods
We performed a prospective study of 90 patients, treated with PEX for TMAs from a single institution over a 36 month period, January 1st 2013 – December 31st 2015. We recorded: virology on admission and in remission for all patients, allergic reactions to plasma, citrate toxicities associated with PEX, venous thrombotic events (VTE) rates and incidence of central venous access (CVA) line sepsis (which can result in exacerbation of TTP).
Results
Over the 36-month period, a total of 981 PEX procedures were performed (median 9, range 0-37). 62 patient episodes were TTP: 45 females (median age: 47 years; range: 15-89) and 17 males (median age: 49 years; range: 21-79); 51 patient episodes were De Novo presentations (43 idiopathic, 5 HIV, 1 Congenital and 2 Pancreatitis) and 11 were relapsed presentations. 17 patient episodes were HUS / aHUS, of which 12 females and 5 males. 11 patient episodes were ‘Other TMAs’ (8 females and 3 males). Citrate toxicity was 5.3% of PEX, (facial and limb tingling). Plasma reactions were 1.7% of PEX (hives and facial swelling) relieved by anti-histamines. No episodes of anaphylaxis and no TRALI were reported. Two cases of line associated sepsis were recorded and 11 cases of VTE were diagnosed (5 PE; day of PE (range): 5-35; platelets count (range): 35-228; 6 DVT; day of DVT (range): 6-43; platelets count (range): 86-264). Virology was checked for all patients. On admission for Hepatitis B they were subdivided into different groups: 57 patients had no evidence of infection or immunisation, 12 patients had evidence of previous immunisation and 9 patients had previous evidence of Hepatitis B infection. No viral transfer was documented following treatment. HCV Ab on admission: 89 negative, 1 positive. There was no antibody transfer post treatment. Pre PEX HIV: 5 positive, 85 negative. No seroconversion was detected post treatment.
Conclusion
Citrate toxicities are reduced in severity, likely due to shortened PEX with the Optya. Reactions with Octaplas remain minimal, with no severe anaphylaxis noted. VTE events, despite prophylactic LMWH starting when platelets are >50x109/L, occurred in 12% of cases, with 50% completed PEX when VTE was recorded. Adherence to our CVA line policy has resulted in a further reduction to our line related infections. In plasma high volume users, virology is important on admission to establish viral profile of the patients and in the follow-up for checking eventual infectious transmission. To date no viral transfer or antibody transfer or seroconversions were reported post treatment, likely due to safety of OctaplasLG.
Session topic: E-poster
Keyword(s): Thrombotic microangiopathy, Thrombotic thrombocytopenic purpura (TTP)
Type: Eposter Presentation
Background
Thrombotic thrombocytopenic purpura (TTP) is a rare and acute disorder and plasma exchange (PEX) remains the life-saving therapeutic procedure in patients with TTP and other thrombotic microangiopathic anemias (TMA). OctaplasLG (Octapharma), a virally inactivated prion reducing plasma, has replaced the Solvent-Detergent Fresh-Frozen Plasma (Octaplas®; Octapharma) to improve the safety of plasma.
Aims
Aim of this study was to assess safety of OctaplasLG administration for patients undergoing PEX.
Methods
We performed a prospective study of 90 patients, treated with PEX for TMAs from a single institution over a 36 month period, January 1st 2013 – December 31st 2015. We recorded: virology on admission and in remission for all patients, allergic reactions to plasma, citrate toxicities associated with PEX, venous thrombotic events (VTE) rates and incidence of central venous access (CVA) line sepsis (which can result in exacerbation of TTP).
Results
Over the 36-month period, a total of 981 PEX procedures were performed (median 9, range 0-37). 62 patient episodes were TTP: 45 females (median age: 47 years; range: 15-89) and 17 males (median age: 49 years; range: 21-79); 51 patient episodes were De Novo presentations (43 idiopathic, 5 HIV, 1 Congenital and 2 Pancreatitis) and 11 were relapsed presentations. 17 patient episodes were HUS / aHUS, of which 12 females and 5 males. 11 patient episodes were ‘Other TMAs’ (8 females and 3 males). Citrate toxicity was 5.3% of PEX, (facial and limb tingling). Plasma reactions were 1.7% of PEX (hives and facial swelling) relieved by anti-histamines. No episodes of anaphylaxis and no TRALI were reported. Two cases of line associated sepsis were recorded and 11 cases of VTE were diagnosed (5 PE; day of PE (range): 5-35; platelets count (range): 35-228; 6 DVT; day of DVT (range): 6-43; platelets count (range): 86-264). Virology was checked for all patients. On admission for Hepatitis B they were subdivided into different groups: 57 patients had no evidence of infection or immunisation, 12 patients had evidence of previous immunisation and 9 patients had previous evidence of Hepatitis B infection. No viral transfer was documented following treatment. HCV Ab on admission: 89 negative, 1 positive. There was no antibody transfer post treatment. Pre PEX HIV: 5 positive, 85 negative. No seroconversion was detected post treatment.
Conclusion
Citrate toxicities are reduced in severity, likely due to shortened PEX with the Optya. Reactions with Octaplas remain minimal, with no severe anaphylaxis noted. VTE events, despite prophylactic LMWH starting when platelets are >50x109/L, occurred in 12% of cases, with 50% completed PEX when VTE was recorded. Adherence to our CVA line policy has resulted in a further reduction to our line related infections. In plasma high volume users, virology is important on admission to establish viral profile of the patients and in the follow-up for checking eventual infectious transmission. To date no viral transfer or antibody transfer or seroconversions were reported post treatment, likely due to safety of OctaplasLG.
Session topic: E-poster
Keyword(s): Thrombotic microangiopathy, Thrombotic thrombocytopenic purpura (TTP)
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