The role of thrombocytapheresis in the management of extreme thrombocytosis: a 6 years’ experience from a tertiary care center

Background. According to the American Society for Apheresis (ASFA) guidelines, thrombocytapheresis is a Category II indication in symptomatic patients and is aCategory III indication when used as secondary or prophylactic treatment. The roleof thrombocytapheresis is to prevent untoward complications that might occur evenbefore the cytoreductive agents can exert their action.Methods. A retrospective analysis of patients who underwent thrombocytapheresisbetween 2012 to 2018 was conducted. Demographic details, complete blood counts,diagnosis and indication for thrombocytapheresis were noted.Results. A total of 12 patients with thrombocytosis were included in the study. Thecause of thrombocytosis was primary in 3 (25%) patients and secondary in 9 (75%)patients. The average percentage reduction in platelet count was 47.1% (range12.3%-65.64%). There was a significant decrease in platelet count, platelet crit, andmean platelet volume after the procedure when compared to pre-procedure.Conclusion. Thrombocytapheresis selectively reduces platelet counts with noeffect on other cellular and plasma components. The role of thrombocytapheresisin extreme thrombocytosis is to be considered for an immediate decrease in plateletcount and to minimize the risks associated with thrombocytosis