Evaluation of a new polyacrolein microsphere (acrobead) protein A column: an in vitro study using the blood of patients with immune thrombocytopenia or malignancies

The present study describes the use of a new polyacrolein microsphere (acrobead) protein A column. This method enables immunomodulation by the perfusion of whole blood. The efficacy of the column and its adverse effects following perfusion of blood of patients with immune thrombocytopenic purpura (ITP) or malignancies were investigated. Concurrent experiments in which blood was perfused through an acrobead lactoglobulin column were carried out. Cellular blood components were mildly affected during the procedure. A moderate decrease in platelet number, to a nadir of 90 × 10(3) per microL (90 × 10(9)/L), was documented. During the hemoperfusion of ITP patients' blood, plasma hemoglobin reached levels of 25 to 40 mg per dL, a level similar to that found in banked blood during storage. Plasma tumor necrosis factor level, which serves as an indicator of monocytic activation, increased after 90 minutes of hemoperfusion. IgG and immune complexes were removed. The specific activities (removal of mg Ig/mL bead) of acrobead protein A columns, using blood from patients with ITP or malignancies, were 4.9 and 4.5 mg IgG per mL of bead, respectively. The diminution of platelet‐specific IgG in the plasma of patients with ITP was documented as well. There was no activation of the fibrinolytic system as examined by D‐dimers. The use of this new technique, which incorporates the method of direct hemoperfusion, is suggested for future clinical studies. 1992 AABB