Therapeutic Thrombocytapheresis as an Important Tool in the Management of Symptomatic Hyperthrombocytosis: A Single-Institution Experience from India.

Background & Objectives: Hyperthrombocytosis may cause acquired thrombosis-related symptoms and fatal vascular complications. Currently, therapeutic platelet reduction (TPR) with medical therapy remains the mainstay of hyperthrombocytosis management. We encounter patients with high platelet counts with requests for TPR. Here, we share our experience of TPR procedures in patients with symptomatic hyperthrombocytosis due to various underlying etiologies. Methods: The study from January 2013 to October 2020 included 36 patients of hyperthrombocytosis who underwent 82 TPR procedures by apheresis technology. Patient details were obtained from the treatment file and all procedures were performed following recommended instructions and protocol. Statistical analysis was done using the SPSS statistical package. Results: The median age of patients was 53 years with mean hemoglobin, platelet count, plateletcrit, and platelet distribution width of 9.9 g/dL, 1711.3 × 106/mL, 0.57%, and 43.4%, respectively. A total of 26 patients had primary thrombocytosis. The mean TPR procedure time, whole blood volume processed, and anticoagulant used were 162 min, 5070 mL, and 430.3 mL, respectively. The mean reduction of platelets in patients who underwent two and three procedures was 72.4% and 82.7%, respectively (P = 0.003). Conclusion: We conclude that TPR is a useful method in reducing platelet count rapidly in hyperthrombocytosis. It relieves patients of acute symptoms and prevents thrombotic events. The decision to perform TPR should be individualized and based on the clinical scenario, degree of thrombocytosis, and risk factors associated with TPR procedures. [ABSTRACT FROM AUTHOR]