Suchergebnisse

Therapeutic plasma exchange (TPE) is used to treat more than 60 diseases worldwide and has drawn growing interest. Little is known about the current situation of TPE activity in Turkey, so we developed a survey to obtain information about this timely topic. We collected data on TPE from 28 apheresis units throughout Turkey. We performed a total of 24,912 TPE procedures with 3203 patients over the past decade. Twenty years ago, the majority of procedures were performed for neurological and hematological disorders, and today, most TPE procedures are done for the same reasons. The only historical change has been an increase in TPE procedures in renal conditions. Currently, renal conditions were more frequently an indication for TPE than rheumatic conditions. Fresh frozen plasma was the most frequently used replacement fluid, followed by 5% albumin, used in 57.9% and 34.6% of procedures, respectively. The most frequently used anticoagulants in TPE were ACD-A and heparin/ACD-A, used with 1671 (52.2%) and 1164 (36.4%) patients, respectively. The frequency of adverse events (AEs) was 12.6%. The most common AEs were hypocalcemia-related symptoms, hypotension, and urticaria. We encountered no severe AEs that led to severe morbidity and mortality. Overall, more than two thirds of the patients showed improvement in the underlying disease. Here, we report on a nationwide survey on TPE activity in Turkey. We conclude that there has been a great increase in apheresis science, and the number of TPE procedures conducted in Turkey has increased steadily over time. Finally, we would like to point out that our past experiences and published international guidelines were the most important tools in gaining expertise regarding TPE. ; C1 [Korkmaz, Serdal] Univ Hlth Sci, Kayseri Training & Res Hosp, Dept Hematol, Kayseri, Turkey. ; [Medeni, Serife Solmaz] Univ Hlth Sci, Bozyaka Training & Res Hosp, Dept Hematol, Izmir, Turkey. ; [Demirkan, Fatih] Dokuz Eylul Univ, Dept Internal Med, Div Hematol, Fac Med,HCT Unit, Izmir, Turkey. ; [Besisik, Sevgi Kalayoglu; Dadin, Senem Altay] Istanbul Univ, Istanbul Fac Med, Dept Internal Med, Div Hematol, Istanbul, Turkey. ; [Cagliyan, Gulsum Akgun; Hacioglu, Sibel Kabukcu; Sari, Ismail] Pamukkale Univ, Dept Internal Med, Div Hematol, Denizli, Turkey. ; [Sahin, Deniz Goren] Istanbul Bilim Univ, Sch Med, Dept Hematol, Istanbul, Turkey. ; [Sahin, Deniz Goren; Arat, Mutlu] Sisli Florence Nightingale Hosp, Stem Cell Transplantat Unit, Istanbul, Turkey. ; [Dagdas, Simten; Ozet, Gulsum] Ankara Numune Training & Res Hosp, Dept Hematol, Ankara, Turkey. ; [Kutlu, Nermin; Akyol, Tulay Karaagac] Hacettepe Univ, Sch Med, Therapeut Apheresis Unit, Ankara, Turkey. ; [Ozcebe, Osman Ilhami] Hacettepe Univ, Sch Med, Dept Hematol, Ankara, Turkey. ; [Teke, Hava Uskudar] Eskisehir Osmangazi Univ, Sch Med, Dept Internal Med, Div Hematol, Eskisehir, Turkey. ; [Unal, Demet Kiper; Guner, Naile; Payzin, Bahriye] Izmir Katip Celebi Univ, Ataturk Training & Res Hosp, Dept Hematol, Izmir, Turkey. ; [Tombak, Anil] Mersin Univ, Fac Med, Dept Internal Med, Div Heamatol, Mersin, Turkey. ; [Celik, Halil] Mersin Univ, Fac Med, Dept Internal Med, Mersin, Turkey. ; [Bay, Ilker; Kiki, Ilhami] Ataturk Univ, Sch Med, Dept Internal Med, Div Hematol, Erzurum, Turkey. ; [Ozgur, Gokhan] Gulhane Training & Res Hosp, Hematol & HCT Clin, Ankara, Turkey. ; [Erkurt, Mehmet Ali; Kuku, Irfan] Inonu Univ, Fac Med, Dept Internal Med, Div Hematol, Malatya, Turkey. ; [Ozatli, Duzgun; Meletli, Ozgur] Ondokuz Mayis Univ, Fac Med, Dept Hematol, Samsun, Turkey. ; [Demircioglu, Sinan; Demir, Cengiz] Yuzuncu Yil Univ, Fac Med, Dept Internal Med, Div Hematol, Van, Turkey. ; [Kurtoglu, Erdal] Univ Hlth Sci, Antalya Training & Res Hosp, Dept Hematol, Antalya, Turkey. ; [Vural, Filiz; Tobu, Mahmut] Ege Univ, Fac Med, Dept Internal Med, Div Hematol, Izmir, Turkey. ; [Karakus, Abdullah; Ayyildiz, Orhan] Dicle Univ, Fac Med, Dept Internal Med, Div Hematol, Diyarbakir, Turkey. ; [Dal, Mehmet Sinan; Altuntas, Fevzi] Univ Hlth Sci, Ankara Oncol Training & Res Hosp, Dept Hematol, Ankara, Turkey. ; [Dal, Mehmet Sinan; Altuntas, Fevzi] Univ Hlth Sci, Ankara Oncol Training & Res Hosp, BMT Unit, Ankara, Turkey. ; [Ozturk, Berna Afacan; Albayrak, Murat] Univ Hlth Sci, Diskapi Yildirim Beyazit Training & Res Hosp, Hematol & HCT Clin, Ankara, Turkey. ; [Ocakci, Serkan] Med Pk Izmir Hosp, Dept Hematol, Izmir, Turkey. ; [Bolaman, Zahit; Cagirgan, Seckin] Adnan Menderes Univ, Fac Med, Dept Internal Med, Div Hematol, Aydin, Turkey. ; [Sonmez, Mehmet] Karadeniz Tech Univ, Fac Med, Dept Internal Med, Div Hematol, Trabzon, Turkey. ; [Karakus, Volkan] Mugla Sitki Kocman Univ, Dept Hematol, Training & Res Hosp, Mugla, Turkey. ; [Sevindik, Omur Gokmen] Firat Univ, Fac Med, Dept Internal Med, Div Hematol, Elazig, Turkey. ; [Berber, Ilhami] Malatya Training & Res Hosp, Div Hematol, Malatya, Turkey. ; [Dogu, Mehmet Hilmi] Istanbul Training & Res Hosp, Hematol Clin, Istanbul, Turkey. ; [Gulturk, Emine] Kartal Dr Lutfi Kirdar Training & Res Hosp, Dept Internal Med, Div Hematol, Istanbul, Turkey. ; [Ulas, Turgay] Near East Univ, Dept Internal Med, Div Hematol, Nicosia, Cyprus. ; [Altuntas, Fevzi] Yildirim Beyazit Univ, Fac Med, Dept Internal Med, Div Hematol, Ankara, Turkey.

Therapeutic plasma exchange (TPE) is used to treat more than 60 diseases worldwide and has drawn growing interest. Little is known about the current situation of TPE activity in Turkey, so we developed a survey to obtain information about this timely topic. We collected data on TPE from 28 apheresis units throughout Turkey. We performed a total of 24,912 TPE procedures with 3203 patients over the past decade. Twenty years ago, the majority of procedures were performed for neurological and hematological disorders, and today, most TPE procedures are done for the same reasons. The only historical change has been an increase in TPE procedures in renal conditions. Currently, renal conditions were more frequently an indication for TPE than rheumatic conditions. Fresh frozen plasma was the most frequently used replacement fluid, followed by 5% albumin, used in 57.9% and 34.6% of procedures, respectively. The most frequently used anticoagulants in TPE were ACD-A and heparin/ACD-A, used with 1671 (52.2%) and 1164 (36.4%) patients, respectively. The frequency of adverse events (AEs) was 12.6%. The most common AEs were hypocalcemia-related symptoms, hypotension, and urticaria. We encountered no severe AEs that led to severe morbidity and mortality. Overall, more than two thirds of the patients showed improvement in the underlying disease. Here, we report on a nationwide survey on TPE activity in Turkey. We conclude that there has been a great increase in apheresis science, and the number of TPE procedures conducted in Turkey has increased steadily over time. Finally, we would like to point out that our past experiences and published international guidelines were the most important tools in gaining expertise regarding TPE. ; C1 [Korkmaz, Serdal] Univ Hlth Sci, Kayseri Training & Res Hosp, Dept Hematol, Kayseri, Turkey. ; [Medeni, Serife Solmaz] Univ Hlth Sci, Bozyaka Training & Res Hosp, Dept Hematol, Izmir, Turkey. ; [Demirkan, Fatih] Dokuz Eylul Univ, Dept Internal Med, Div Hematol, Fac Med,HCT Unit, Izmir, Turkey. ; [Besisik, Sevgi Kalayoglu; Dadin, Senem Altay] Istanbul Univ, Istanbul Fac Med, Dept Internal Med, Div Hematol, Istanbul, Turkey. ; [Cagliyan, Gulsum Akgun; Hacioglu, Sibel Kabukcu; Sari, Ismail] Pamukkale Univ, Dept Internal Med, Div Hematol, Denizli, Turkey. ; [Sahin, Deniz Goren] Istanbul Bilim Univ, Sch Med, Dept Hematol, Istanbul, Turkey. ; [Sahin, Deniz Goren; Arat, Mutlu] Sisli Florence Nightingale Hosp, Stem Cell Transplantat Unit, Istanbul, Turkey. ; [Dagdas, Simten; Ozet, Gulsum] Ankara Numune Training & Res Hosp, Dept Hematol, Ankara, Turkey. ; [Kutlu, Nermin; Akyol, Tulay Karaagac] Hacettepe Univ, Sch Med, Therapeut Apheresis Unit, Ankara, Turkey. ; [Ozcebe, Osman Ilhami] Hacettepe Univ, Sch Med, Dept Hematol, Ankara, Turkey. ; [Teke, Hava Uskudar] Eskisehir Osmangazi Univ, Sch Med, Dept Internal Med, Div Hematol, Eskisehir, Turkey. ; [Unal, Demet Kiper; Guner, Naile; Payzin, Bahriye] Izmir Katip Celebi Univ, Ataturk Training & Res Hosp, Dept Hematol, Izmir, Turkey. ; [Tombak, Anil] Mersin Univ, Fac Med, Dept Internal Med, Div Heamatol, Mersin, Turkey. ; [Celik, Halil] Mersin Univ, Fac Med, Dept Internal Med, Mersin, Turkey. ; [Bay, Ilker; Kiki, Ilhami] Ataturk Univ, Sch Med, Dept Internal Med, Div Hematol, Erzurum, Turkey. ; [Ozgur, Gokhan] Gulhane Training & Res Hosp, Hematol & HCT Clin, Ankara, Turkey. ; [Erkurt, Mehmet Ali; Kuku, Irfan] Inonu Univ, Fac Med, Dept Internal Med, Div Hematol, Malatya, Turkey. ; [Ozatli, Duzgun; Meletli, Ozgur] Ondokuz Mayis Univ, Fac Med, Dept Hematol, Samsun, Turkey. ; [Demircioglu, Sinan; Demir, Cengiz] Yuzuncu Yil Univ, Fac Med, Dept Internal Med, Div Hematol, Van, Turkey. ; [Kurtoglu, Erdal] Univ Hlth Sci, Antalya Training & Res Hosp, Dept Hematol, Antalya, Turkey. ; [Vural, Filiz; Tobu, Mahmut] Ege Univ, Fac Med, Dept Internal Med, Div Hematol, Izmir, Turkey. ; [Karakus, Abdullah; Ayyildiz, Orhan] Dicle Univ, Fac Med, Dept Internal Med, Div Hematol, Diyarbakir, Turkey. ; [Dal, Mehmet Sinan; Altuntas, Fevzi] Univ Hlth Sci, Ankara Oncol Training & Res Hosp, Dept Hematol, Ankara, Turkey. ; [Dal, Mehmet Sinan; Altuntas, Fevzi] Univ Hlth Sci, Ankara Oncol Training & Res Hosp, BMT Unit, Ankara, Turkey. ; [Ozturk, Berna Afacan; Albayrak, Murat] Univ Hlth Sci, Diskapi Yildirim Beyazit Training & Res Hosp, Hematol & HCT Clin, Ankara, Turkey. ; [Ocakci, Serkan] Med Pk Izmir Hosp, Dept Hematol, Izmir, Turkey. ; [Bolaman, Zahit; Cagirgan, Seckin] Adnan Menderes Univ, Fac Med, Dept Internal Med, Div Hematol, Aydin, Turkey. ; [Sonmez, Mehmet] Karadeniz Tech Univ, Fac Med, Dept Internal Med, Div Hematol, Trabzon, Turkey. ; [Karakus, Volkan] Mugla Sitki Kocman Univ, Dept Hematol, Training & Res Hosp, Mugla, Turkey. ; [Sevindik, Omur Gokmen] Firat Univ, Fac Med, Dept Internal Med, Div Hematol, Elazig, Turkey. ; [Berber, Ilhami] Malatya Training & Res Hosp, Div Hematol, Malatya, Turkey. ; [Dogu, Mehmet Hilmi] Istanbul Training & Res Hosp, Hematol Clin, Istanbul, Turkey. ; [Gulturk, Emine] Kartal Dr Lutfi Kirdar Training & Res Hosp, Dept Internal Med, Div Hematol, Istanbul, Turkey. ; [Ulas, Turgay] Near East Univ, Dept Internal Med, Div Hematol, Nicosia, Cyprus. ; [Altuntas, Fevzi] Yildirim Beyazit Univ, Fac Med, Dept Internal Med, Div Hematol, Ankara, Turkey.

Fast and reliable detection of patients with severe and heterogeneous illnesses is a major goal of precision medicine. Patients with leukaemia can be identified using machine learning on the basis of their blood transcriptomes. However, there is an increasing divide between what is technically possible and what is allowed, because of privacy legislation. Here, to facilitate the integration of any medical data from any data owner worldwide without violating privacy laws, we introduce Swarm Learning—a decentralized machine-learning approach that unites edge computing, blockchain-based peer-to-peer networking and coordination while maintaining confidentiality without the need for a central coordinator, thereby going beyond federated learning. To illustrate the feasibility of using Swarm Learning to develop disease classifiers using distributed data, we chose four use cases of heterogeneous diseases (COVID-19, tuberculosis, leukaemia and lung pathologies). With more than 16,400 blood transcriptomes derived from 127 clinical studies with non-uniform distributions of cases and controls and substantial study biases, as well as more than 95,000 chest X-ray images, we show that Swarm Learning classifiers outperform those developed at individual sites. In addition, Swarm Learning completely fulfils local confidentiality regulations by design. We believe that this approach will notably accelerate the introduction of precision medicine.