Issues in Therapeutic Apheresis

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Abstract
IN recent years therapeutic partial plasma exchange (removal of large amounts of the patient's plasma and replacement with crystalloid and colloid) and therapeutic cytapheresis (removal of cellular elements) have been used in the treatment of a variety of diseases. In this issue of the Journal one example of such use is reported: the combined removal of plasma and lymphocytes in the treatment of a small number of patients with severe rheumatoid arthritis.1 The study was well designed, with patients prospectively randomized to receive either "lymphoplasmapheresis" or sham apheresis. The results proved inconclusive. Whereas some measures of disease severity improved significantly . . .