{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T15:00:55Z","timestamp":1769094055314,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T00:00:00Z","timestamp":1591660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Therapeutic plasma exchange (TPE) is traditionally performed for hyperviscosity, neuropathy and to mitigate renal injury in the setting of high clonal free light chain burden in patients with multiple myeloma (MM) with unknown clinical benefit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Retrospective study of adults \u226518\u2009years with MM who received TPE in the in\u2010patient setting in the United States from 1993 to 2015. We examined the temporal trends of TPE utilization in MM hospitalizations, hospital charges, in\u2010hospital mortality, and length of hospitalization and the predictors of in\u2010hospital mortality and length of hospitalizations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The number of MM\u2010hospitalizations for TPE in adults increased significantly from 1993 to 2015 (1% in 1993\u20101999 to 2.1% in 2008\u20102015 of all MM discharges, <jats:italic>P<\/jats:italic> for trend &lt;.0001). About 70% of TPE recipients had acute kidney injury (AKI). The median hospital charges increased 5\u2010fold during the time period ($ 24\u2009407 to $ 113\u2009496; <jats:italic>P<\/jats:italic> for trend &lt;.0001). In\u2010hospital mortality decreased (17.5% (SE 2.66) in 1993\u20101997 to 8.7% (1.39) in 2007 to 2013) <jats:italic>P<\/jats:italic> for trend &lt;.005) while the length of stay remained unchanged (11.2\u2009days vs 11.9\u2009days, <jats:italic>P<\/jats:italic> for trend 0.17). On adjusted analysis, significant predictors of in\u2010hospital mortality among MM TPE recipients include, Charlson Comorbidity Index (CCI) (3 vs 2 adjusted odds ratio, aOR 2.16, 95% CI 1.26\u20103.71; <jats:italic>P<\/jats:italic> = .005), year (continuous) (aOR 0.93, 95% CI 0.90\u20100.96; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and race (other vs white; aOR 0.44, 95% CI 0.25\u20100.78; <jats:italic>P<\/jats:italic> = 0.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There has been a substantial increase in the use and associated cost of TPE in hospitalized MM patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.21798","type":"journal-article","created":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T22:58:51Z","timestamp":1591743531000},"page":"307-315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Trends in the use of therapeutic plasma exchange in multiple myeloma"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4377-9742","authenticated-orcid":false,"given":"Binod","family":"Dhakal","sequence":"first","affiliation":[{"name":"Division of Hematology\/Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Rein","sequence":"additional","affiliation":[{"name":"Division of Biostatistics Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lakshmi Kant","family":"Pathak","sequence":"additional","affiliation":[{"name":"Division of Nephrology University of Illinois  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Gloria","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aniko","family":"Szabo","sequence":"additional","affiliation":[{"name":"Division of Biostatistics Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Smith","family":"Giri","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology University of Alabama  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurabh","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"Hamadani","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agne","family":"Paner","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology\/Cell Therapy Rush University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand","family":"Padmanabhan","sequence":"additional","affiliation":[{"name":"Blood Center of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siegfried","family":"Janz","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1092-5643","authenticated-orcid":false,"given":"Anita","family":"D'Souza","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parameswaran","family":"Hari","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3233\/CH-131691"},{"issue":"1","key":"e_1_2_7_3_1","first-page":"69","article-title":"Plasmapheresis for hyperviscosity syndrome in macroglobulinemia Waldenstrom and multiple myeloma: influence on blood rheology and the microcirculation","volume":"119","author":"Reinhart WH","year":"1992","journal-title":"J Lab Clin Med"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2011.03380.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.65.0044"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-143-11-200512060-00005"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2011.168"},{"issue":"3","key":"e_1_2_7_8_1","first-page":"207","article-title":"Multiple myeloma and light chain\u2010associated nephropathy at end\u2010stage renal disease in the United States: patient characteristics and survival","volume":"56","author":"Abbott KC","year":"2001","journal-title":"Clin Nephrol"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.05.020"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2014.06.023"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfp679"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21705"},{"key":"e_1_2_7_13_1","volume-title":"Healthcare Cost and Utilization Project (HCUP)","author":"Documentation. HND","year":"2018"},{"key":"e_1_2_7_14_1","volume-title":"Top Picks: Price Indexes","author":"US Bureau of Labor Statistics, Division of Consumer Prices and Price Indexes","year":"2017"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(92)90133-8"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1990.00390160111022"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1988.127"},{"key":"e_1_2_7_18_1","unstructured":"MyElomaGG. Renal Impairment Trial: Adjunctive Plasma Exchange in Patients With Newly Diagnosed Multiple Myeloma and Acute Renal Failure (MERIT) NCT00416897; ISRCTN37161699; 2013. Available from:http:\/\/www.controlled-trials. com (Updated February 11 2013)."},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-4758.2010.00481.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000013424"},{"issue":"1","key":"e_1_2_7_21_1","first-page":"1","article-title":"Prognostic factors and effectiveness of treatment in acute renal failure due to multiple myeloma: a review of 50 cases. Report of the Italien Renal Immunopathology Group","volume":"28","author":"Pozzi C","year":"1987","journal-title":"Clin Nephrol"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.8777.1"},{"key":"e_1_2_7_23_1","first-page":"104","volume-title":"Serum Free Light Chain Analysis","author":"Ar B","year":"2006"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.126.2.207"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.33.8.786"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006080821"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.17924"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(19)30014-6"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2013.313"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2008.108"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1101834"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjca.21798","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.21798","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jca.21798","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.21798","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T10:42:46Z","timestamp":1693737766000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.21798"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,9]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1002\/jca.21798"],"URL":"https:\/\/doi.org\/10.1002\/jca.21798","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,9]]},"assertion":[{"value":"2020-03-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}