Safety and effectiveness of apheresis in the treatment of infectious diseases: A systematic review

Odedra, A. and Lalloo, D. G. and Kennedy, G. and Llewellyn, S. and McCarthy, J. S.

J Infect (2019) 79: 513–520

DOI: 10.1016/j.jinf.2019.09.014

Abstract

OBJECTIVES: Apheresis has been used as adjunctive treatment of severe falciparum malaria, loiasis and babesiosis. This systematic review aimed to investigate the safety and efficacy of apheresis in the treatment of these conditions. METHODS: MEDLINE, PUBMED, EMBASE and CINAHL databases were searched to identify studies published between January 1969 and March 2018 involving patients treated using apheresis for severe falciparum malaria, loiasis or babesiosis. Data extracted included details about the apheresis intervention, populations, study methods and outcomes relating to efficacy and safety. RESULTS: A total of 67 publications met the inclusion criteria and were included in the data synthesis, 36 for malaria (70 cases), 17 for babesiosis (22 cases) and 14 for loiasis (34 cases). Publications were case reports, case series, and cohort studies; there were no randomised controlled trials identified. Potential publication bias was considered to be high. CONCLUSIONS: Systematic review of the literature suggests that apheresis may be a useful adjunct in the treatment of patients hospitalised for babesiosis, and prior to chemotherapy in loiasis with microfilarial count \textgreater8000 parasites/mL. Data does not support the use of apheresis in patients with severe falciparum malaria.

Citation

Odedra, A., Lalloo, D. G., Kennedy, G., Llewellyn, S., & McCarthy, J. S. (2019). Safety and effectiveness of apheresis in the treatment of infectious diseases: A systematic review. J Infect, 79(6), 513–520. https://doi.org/10.1016/j.jinf.2019.09.014 Male, Adult, Aged, Aged, 80 and over, Female, Humans, Middle Aged, Adolescent, Child, Child, Preschool, Infant, Young Adult, Treatment Outcome, Cohort Studies, Hospitals, Infant, Newborn, *Plasmapheresis, *Malaria, *Babesiosis, *Apheresis, *Babesia, *Erythrocytapheresis, *Loa loa, *Loiasis, *Plasma exchange, *Red cell exchange, Babesiosis/*therapy, Blood Component Removal/*adverse effects/*methods, Loiasis/*therapy, Malaria, Falciparum/*therapy

Keywords

• Male
• Adult
• Aged
• Aged
• 80 and over
• Female
• Humans
• Middle Aged
• Adolescent
• Child
• Child
• Preschool
• Infant
• Young Adult
• Treatment Outcome
• Cohort Studies
• Hospitals
• Infant
• Newborn
• *Plasmapheresis
• *Malaria
• *Babesiosis
• *Apheresis
• *Babesia
• *Erythrocytapheresis
• *Loa loa
• *Loiasis
• *Plasma exchange
• *Red cell exchange
• Babesiosis/*therapy
• Blood Component Removal/*adverse effects/*methods
• Loiasis/*therapy
• Malaria
• Falciparum/*therapy