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This monograph provides a comprehensive review of the indications, mechanisms, clinical applications, and evidence supporting TPE across a spectrum of autoimmune neuromuscular conditions. TPE is utilized in both acute and maintenance settings, particularly when rapid immunomodulation is required. However, sustained disease control frequently requires combination therapy with immunosuppressive or immunomodulatory agents. Current recommendations are guided by the American Society for Apheresis (ASFA) guidelines, which categorize disorders into four levels (I\u2013IV) based on quality of evidence and clinical utility, with strength of recommendations graded using the GRADE framework. Strong evidence supports the use of TPE in conditions such as Guillain\u2013Barr\u00e9 syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), and myasthenia gravis (MG). 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