eprintid: 10087936
rev_number: 21
eprint_status: archive
userid: 608
dir: disk0/10/08/79/36
datestamp: 2019-12-13 14:10:25
lastmod: 2021-09-27 22:36:37
status_changed: 2019-12-13 14:10:25
type: article
metadata_visibility: show
creators_name: Eyre, M
creators_name: Hacohen, Y
creators_name: Barton, C
creators_name: Hemingway, C
creators_name: Lim, M
title: Therapeutic plasma exchange in paediatric neurology: a critical review and proposed treatment algorithm
ispublished: pub
subjects: GOSH
divisions: UCL
divisions: B02
divisions: C07
divisions: D07
divisions: F87
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
abstract: Therapeutic plasma exchange (TPE) has been a key immunotherapeutic strategy in numerous neurological syndromes, predominantly during the acute phase of illness. This paper reviews the indications, strength of evidence, and safety of TPE in children with neurological conditions. The rarity of these immune conditions in children, alongside an often incomplete understanding of their pathobiology, has limited the development of a robust scientific rationale for TPE therapy and the feasibility of conducting larger controlled trials. TPE continues to be used, but is a costly therapy with common adverse effects. Uncertainty remains over how to compare the different TPE methods, the optimal dosage of therapy, and monitoring and integration of TPE with other immunotherapies. Further studies are also required to define the indications and benefits of TPE and assess evolving technologies such as immunoadsorption. /

What this paper adds: Studies investigating therapeutic plasma exchange (TPE) are small and mainly uncontrolled.
They provide evidence for the efficacy of TPE in childhood neuro‐inflammatory conditions.
TPE is generally well tolerated provided key adverse effects are anticipated and avoided.
Systematic dosing and objective assessment of treatment effect should be priorities for future research.
date: 2018-08
date_type: published
publisher: WILEY
official_url: https://doi.org/10.1111/dmcn.13925
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1698022
doi: 10.1111/dmcn.13925
lyricists_name: Hacohen, Yael
lyricists_id: YHACO24
actors_name: Allington-Smith, Dominic
actors_id: DAALL44
actors_role: owner
full_text_status: public
publication: Developmental Medicine & Child Neurology
volume: 60
number: 8
pagerange: 765-779
pages: 15
citation:        Eyre, M;    Hacohen, Y;    Barton, C;    Hemingway, C;    Lim, M;      (2018)    Therapeutic plasma exchange in paediatric neurology: a critical review and proposed treatment algorithm.                   Developmental Medicine & Child Neurology , 60  (8)   pp. 765-779.    10.1111/dmcn.13925 <https://doi.org/10.1111/dmcn.13925>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10087936/3/Hacohen_PLEX%20review%20text%20and%20tables%2003_03_18%20%28final%29.pdf